ECMO in Italy: Early Results of the First National Survey on Organization, Training and Network Integration

Abstract

Introduction. Extracorporeal membrane oxygenation (ECMO) is a life-supporting system whose outcomes are strongly influenced by organizational factors. Despite recommendations from the Extracorporeal Life Support Organization (ELSO), there is a lack of national guidelines that uniformly define the requirements of the ECMO center.

Methods. A national cross-sectional survey was conducted. A questionnaire based on ELSO recommendations was sent to 83 ECMO centers, 64 of which have responded to date.

Results. The centers are spread throughout the country, with a concentration in northern Italy. Most provide both veno-venous and veno-arterial ECMO, but with varying activity volumes: 50% perform fewer than 20 procedures per year. A formalized multidisciplinary team is present in 59.4% of centers. ECMO training programs were reported in 57.8% of cases, with limited nursing participation. Organizational gaps include a lack of formal ECMO programs and teams, as well as limited integration into ECMO networks.

Discussion. This study is the first attempt to national mapping of the organization of the ECMO center in Italy and revealed significant differences in the organization of the ECMO programs in Italy. Although this variability does not necessarily imply poor clinical quality, it suggests the need for more coordinated and integrated models. The strong interest of centers in the development of ECMO networks indicates a favorable environment to develop a national model.