• List circuit monitoring tools.
• List the considerations for selecting the appropriate ECMO cannula.
• Outline the process of percutaneous cannulation
• Discuss the role of ultrasound in cannulation
• Discuss anticoagulation monitoring on ECMO.
• List standard management strategies for respiratory failure
• Discuss the rationale of VV ECMO in respiratory failure
• Describe the concept of native lung rest
• Troubleshoot recirculation.
• List standard management strategies for cardiac failure
• Discuss the rationale of VA ECMO in cardiac failure
• Describe the concept of native heart rest.
• Describe ventilator management and blood and gas flow titration for pulmonary support.
• Describe the process of weaning VV ECMO support.
• List exit strategies for the VV ECMO patient.
• Describe the process of weaning VA ECMO support
• List exit strategies for the VA ECMO patient
• List medical and mechanical complications of ECMO.

By the end of this course the participant will be able to: 

• Define what is ECLS/ECMO 
• Describe the different modes of ECMO support 
• List the key milestones in the development of ECMO 
• Define and briefly describe the different types of ECLS; based on support mode (cardiac &/or respiratory support) or canulation site (VV/VA/AV) 
• Describe the ECMO results and growth 
• Describe the value of ELSO and an international ELSO Data Registry
• Describe the main components and composition of an ECMO circuit 
• Explain the physics and working principles of a centrifugal pump 
• Explain the features and working principles of the membrane lung, heater and gas blender 
• Explain how to prepare an ECMO circuit for ECMO initiation  
• Describe the ECMO circuit monitoring (pressures, flow, rpms, O2 saturations, bubbles) and rationale for this 
• Touch on component complications (clinical case !) 
• Describe the differences in ECMO canula design 
• Explain the considerations in selecting a specific ECMO cannula design 
• Explain the choice of canulation site and site of blood drainage/return for VA and VV ECMO 
• Describe the different techniques used for canula placement and rationale for the choice of technique 
• Explain complications of ECMO cannulation 
• Explain optional canulation sites in ECMO supported patients (limb perfusion, direct LV vent) 
• Explain the need for anticoagulation in ECMO supported patients  
• Explain the choices of anticoagulation drugs for patients on ECMO 
• Explain the different modes of anticoagulation monitoring for patients on ECMO 
• Explain the difficult balance between bleeding and clotting, and the possible ways to keep an optimal balance 
• Describe the most common causes of clotting and bleeding complications, and how to prevent or detect 
• Discuss thrombotic complications after ECMO explant 
• Explain the rationale for ECMO support in adults with respiratory failure– what to expect from VV ECMO 
• List the most important indications for ECMO in adult respiratory failure and their outcome 
• Describe how ECMO support can compensate for the failing lungs and allow them to recover 
• Explain the determinants of oxygenation (role of ratio ECMOBF/CO) 
• Describe the management of patients on ECMO, including lung protective ventilation, hemodynamic management, sedation, fluid management, infection control 
• Describe some typical VV ECMO related phenomena :  
• Recirculation; causes, how to detect and to solve 
• Describe how to assess weanability and how to wean a patient from VV ECMO 
• Explain the rationale for ECMO support in adults with cardiac failure – what to expect from VA ECMO 
• List the most important indications for ECMO in adult cardiac failure and their outcome 
• Describe the effects of VA ECMO on left and right ventricles 
• Describe how ECMO support can compensate for the failing heart and allow the heart to recover 
• Describe the management of patients on ECMO, including LV unloading, hemodynamic & ventilation management, sedation, fluid management, infection control 
• Describe some typical VA ECMO related phenomena :  
• Harlequin syndrome; causes, how to detect and to solve 
• Left ventricular distention ; causes, how to detect and prevent 
• Describe how to assess weanability and how to wean a patient from VA ECMO