The extracorporeal membrane oxygenation (ECMO) high-fidelity simulator: the best complementary tool to learn the technique

Extracorporeal membrane oxygenation (ECMO) use in intensive care units (ICUs) has expanded exponentially over the past decade (1) because of increasing scientific evidence (2,3), technological advances and broadened indications (4-6). Its complex management and the need for rapid decision-making processes to counter complications require critical care stakeholders to be constantly updated and trained to care for patients in need of such interventions. Despite the highly challenging management of ECMO patients, well-established training programs are scarce (7,8). To date, the Extracorporeal Life Support Organization, an international body focused on ECMO research and education, recommends traditional educational approaches with lectures and practice with water-drills or animal testing (9). However, because troubleshooting simulations and animal testing are usually expensive and available less often, water-drill-based ECMO training might be limited. On the other hand, because it seems to be highly effective, with long-lasting take-away skills, ECMO-simulation-based apprenticeship could be particularly useful for intensivists (10,11). Using this pedagogical tool to train ECMO users could offer promising outcomes but have rarely been studied (12,13). In addition, most published studies lacked control subjects to scientifically compare to simulation-training performance in the context of ECMO (12,13).