J Extra Corpor Technol 2026, 58, 51--56 Ó The Author( s), published by EDP Sciences, 2026 https:// doi. org / 10.1051 / ject / 2025040
Available online at: ject. edpsciences. org
ORIGINAL ARTICLE
A bedside staffing model with perfusionists for pediatric extracorporeal membrane oxygenation( ECMO) at a high-volume center w
Christopher Nemeh( MD) 1, Caitlin Cain-Trivette( MD) 1, Nicholas Schmoke( MD) 1, Caleb Varner( MS, CCP) 2,*, Michael Brewer( MS, CCP) 2, Eunice Clark( MSN, APRN) 3, Holly Ream( MSN, APRN, CNOR) 3, Diana Vargas Chaves( MD) 4, Tarif Choudhury( MD) 5, 6, Steven Stylianos( MD) 1, William Middlesworth( MD) 1, and Eva W. Cheung( MD) 5, 6
1 Division of Pediatric Surgery, Department of Surgery, Columbia University Vagelos College of Physicians and Surgeons / NewYork-Presbyterian Morgan Stanley Children’ s Hospital, 3959 Broadway, New York, NY 10032, USA 2 Department of Perfusion, NewYork-Presbyterian Morgan Stanley Children’ s Hospital, 3959 Broadway, New York, NY 10032, USA 3 Department of Nursing, NewYork-Presbyterian Morgan Stanley Children’ s Hospital, Columbia University Medical Center,
3959 Broadway, New York, NY 10032, USA 4 Division of Pediatric Neonatology, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons / NewYork-Presbyterian Morgan Stanley Children’ s Hospital, 3959 Broadway, New York, NY 10032, USA 5 Division of Pediatric Cardiology, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons / NewYork-Presbyterian Morgan Stanley Children’ s Hospital, 3959 Broadway, New York, NY 10032, USA 6 Division of Pediatric Critical Care and Hospitalist Medicine, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons / NewYork-Presbyterian Morgan Stanley Children’ s Hospital, 3959 Broadway, New York, NY 10032, USA Received 25 April 2025, Accepted 24 July 2025
Abstract – Background: Extracorporeal membrane oxygenation( ECMO) in pediatric patients requires monitoring by specialists to optimize outcomes. Practice variability exists among pediatric ECMO centers across the country. We present a bedside pediatric ECMO staffing model with perfusionists that combines personnel expertise and technology. Methods: At our institution, ECMO care is provided in three intensive care units across one floor. Our primary bedside ECMO provider consists of pediatric perfusionists who provide 24 / 7 coverage of ECMO patients via remote monitoring and hourly bedside rounding. Neonatal and pediatric ECMO patients are supported using the Cardiohelp System TM, which uses Spectrum Medical Quantum Elite Workstation and Variable Input Patient Electronic Records( VIPER) software that remotely delivers ECMO circuit parameters and alarms digitally to a monitor in a workroom and mobile devices. ECMO education and skills are reinforced via dedicated didactic and simulation sessions by an ECMO program coordinator. We compared institutional complication rates to other centers tracked by ELSO. Results: From 2017 to 2023, 289 cannulations were performed, consisting of a total of 62,742 cumulative ECMO hours, of which 92 % of that time there were simultaneous ECMO patients. This rounding model has institutional mortality and complication rates that are comparable to ELSO rates. Conclusion: We describe a bedside ECMO staffing model with perfusionists, in contrast to ECMO specialists seen at other institutions. The complication and mortality rates are comparable to ELSO rates, suggesting the safety of this model. Further exploration regarding resource utilization and costs is warranted.
Key words: Extracorporeal membrane oxygenation, Perfusion, Pediatrics, Critical care, Workforce.
w This was a poster presentation at 41st Annual Childrens National Symposium: ECMO and the Advanced Therapies for Cardiovascular and
Respiratory Failure. Keystone, CO. March 2025 and at American College of Surgeons: Quality and Safety Conference 2024. New York, NY. July 2024. * Corresponding author: varner. caleb @ gmail. com
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