Basic Adult ECMO Course and Simulation Training

As a treatment option for the most critically ill patients, extracorporeal life support (ECLS) or extracorporeal membrane oxygenation (ECMO) is growing in popularity around the world. When used properly, ECMO can save the lives of patients of any age who are experiencing severe circulatory and respiratory failure.
Patients that require ECMO are in a critical condition, and the management of these patients is difficult. In order to implement ECMO successfully in clinical practice, education and expertise are required. Understanding the physiology of ECMO, as well as the risks involved, is essential.

We are pleased to share our experience we have gained over the past years and will offer ECMO training courses in Zurich for participants from all over the world. The courses’ contents are based on the recommendations of the Extracorporeal Life Support Organization (ELSO) and include lectures in the morning, while the afternoons will be spent on simulations, hands-on work and class discussions. Basic knowledge of ECMO therapy and the device components will be taught.
If you are interested, do not hesitate to contact us to discuss and conduct a simulation training. The trainings are possible with four to twelve participants and are conducted at the simulation center of the University Hospital Zurich.

Example Schedule
Day 1

Day 2

Content of the sessions

Session I:
Introduction ECMO overview & History of ECMO (and ELSO?) (different modes of ECMO support, milestones in the development of ECMO)

Session II: Circuit Components Circuit Overview, Cannulas & Tubing, Pump, Membrane Lung and Blender, Pressure Monitoring, Other circuit components

Session III: Cannulation & Configuration Cannulation, VV ECMO configurations, VA ECMO configurations, Cannulation complications

Session IV: Physiology Oxygen delivery & uptake, gas transfer in the membrane lung, hemodynamic monitoring on VV & VA ECMO, drainage insufficiency, return obstruction

Session V: V-V ECMO respiratory failure, patient selection for VV ECMO, Initiation of VV ECMO, VV ECMO maintenance, recirculation, weaning VV ECMO

Session VI: V-A ECMO Cardiac Failure, Patient Selection for VA ECMO, Initiation of VA ECMO, VA Maintenance, Left Ventricular Distention, Differential Oxygenation, Weaning VA ECMO

Session VII: Patient Management Sedation, Physiotherapy, Anticoagulation, Procedures, Renal Replacement Therapy, Hospital Transport

Session VIII: Complications
a) Complications Overview, Neurological Complications, Bleeding, thrombosis, hemolysis, limb ischemia, cardiac arrest during ECMO, HIT
b) blood cell trauma, membrane lung dysfunction, air embolism, pump failure, circuit disruption, accidental decannulation, coming off ECMO emergently

Hands-on sessions

• Training on mannequin (percutaneous implantation): overview material, cannulation techniques, ideally ultrasound-guided
• Priming and troubleshooting with the perfusion simulator: priming the circuit, simulation of gas supply failure, Harlequin syndrome, membrane oxygenator clotting
• eCPR: theoretical and practical aspects: mechanical and medical resuscitation on ECMO, perfusion pressure, flow, simulation insufficient venous drainage, management of left ventricular distension
• Proning on ECMO: practical aspects: practical exercise of proning an ECMO patient, simulation of gas supply failure or venous air entrainment