A Crash Course in ECMO Specialist History

I typically skip over history chapters because they can be a bit boring. However, I needed inspiration for today’s trivia, and it hit me last night while chatting with a seasoned ECMO Specialist. He started sharing stories about the exciting things he’d done over the years and how his career had evolved. It was fascinating!

After I got home, I flipped through the ELSO Training Manual and discovered an entire chapter dedicated to the history of ECMO specialists. And honestly? It’s a pretty exciting story! So, today, I’m diving into the evolution of ECMO Specialists, how they’ve shaped this field, and their critical role in ECMO care.

Timeline of ECMO Specialists:

• Early 1970s: The first clinical ECMO cases were performed using circuits developed in laboratories. These makeshift systems were managed by the same teams of surgeons, perfusionists, and nurses who developed the technology.

• 1975: Approximately 20 successful ECMO cases were reported. The National Institutes of Health (NIH) conducted a clinical trial on adult respiratory failure using ECMO, but the trial showed poor outcomes, temporarily halting most ECMO research.

• 1975-1980: At the University of California, Irvine, ECMO was successfully applied to newborns with respiratory failure. This is where the first ECMO Specialist team was created—comprised of ICU nurses, perfusionists, surgical residents, and medical students.

• 1979: ICU nurse Nancy Wetmore formally described the role of the ECMO Specialist, giving structure to the profession we know today.

• 1980: The ECMO project moved to the University of Michigan, where the first full-time ECMO team was established. This team was a blend of ICU nurses, respiratory therapists, and perfusionists who became the first officially recognized ECMO Specialists.

• 1989: The Extracorporeal Life Support Organization (ELSO) was founded. ELSO helped standardize ECMO practices worldwide, published the first ECMO Specialist Training Manual, and began recording ECMO cases.

• 1991: At Oakland Children’s Hospital, Julie Vilardi led the formation of a nursing-based ECMO Specialist team, refining the model further.

• 1993: ELSO published the first Edition of the ECMO Specialist Training Manual, marking an important step toward formalizing training and certification for ECMO Specialists.

• 1999: The second Edition of the ECMO Specialist Training Manual was published, updating the knowledge and skills required in the evolving ECMO field.

• 2010: The third Edition of the ECMO Specialist Training Manual was published, reflecting advancements in ECMO technology and practices.

• 2018: The fourth and current Edition of the ECMO Specialist Training Manual was published, solidifying modern ECMO practices and the role of the ECMO Specialist.

• 2000s: With advances in ECMO technology, circuits became simpler and safer. This allowed ICU nurses to manage ECMO with additional training, shifting the role of the ECMO Specialist to education, coordination, and standard-setting.

The ECMO Specialist is a new paramedical profession that grew out of the need for specialists to manage prolonged extracorporeal life support. These specialists typically come from nursing, perfusion, or respiratory therapy backgrounds. The ECMO Specialist team manages the ECMO program, from patient care to device management.

If you’d like to dive deeper into the history and details of this role, you can find more in Chapter 1 of the ELSO Training Manual, 4th Edition.

Stay tuned for our next deep dive on Tuesday, where we’ll explore the training and development of ECMO specialists in today’s healthcare systems more.

Did I miss anything? I’d love to hear your thoughts and insights in the comments below!

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Acknowledgments:

I developed three custom GPTs, “AI ECMO Expert,” “ECMO Specialist Handover Practice,” and “Micro Definitions (MD-GPT),” for specialized research. These tools draw primarily from the ELSO Redbook (6th Edition), the ELSO Specialist Training Manual (4th Edition), various research papers, and articles. Additional research was supported by GPT-4o/o1, Claude 3.5 Sonnet/Opus, and Perplexity. Editing was performed with Grammarly. A.I. images and charts were created using Leonardo AI, DALL-E3 AI Image Generator, Microsoft Designer, and Adobe Express. Content for all articles sourced from Extracorporeal Life Support: The ELSO Red Book, 6th Edition, and ECMO Specialist Training Manual, 4th Edition.