Revolutionizing ECMO simulation with affordable yet high-Fidelity technology

Abstract

Simulation-based training (SBT) is becoming a necessity in educating healthcare professionals who work in high-risk environments, such as the intensive care unit (ICU). This applies to extracorporeal membrane oxygenation (ECMO), a complication-burdened life support ICU modality employed to treat patients with circulatory and/or respiratory failure. Additionally, ECMO can quickly restore perfusion, and hence, used in the pre-hospital or emergency setting as an extracorporeal cardiopulmonary resuscitation (E-CPR) strategy or to maintain donors’ organs after circulatory death. Different ECMO simulation models have been reported in the literature. It ranges from simple mannequin and circuit modification with manual control, to hydraulically capable, remotely controlled mannequins, and high-fidelity simulators. However, the common factor in the incumbent practices is the reliance on a functioning ECMO console and circuit components, which introduces a colossal cost barrier and requires active spending to replace ECMO consumables. Reliance of such specialized and potentially scarce pieces of equipment also significantly reduces training opportunities. Furthermore, attempts to improve the simulation paradigm are faced with ever-increasing technical difficulties. For example, basic objectives such as controlling the displayed circuit pressures requires creating a sophisticated hydraulic model. It becomes even more problematic when considering higher level objectives such as simulating blood oxygenation color differentials, or remotely controlling blood gas parameters, displayed on in-line monitors. Hence, there is a need for lower cost, high-fidelity simulation systems with more customization capabilities that meet the expectations and increasing demand for ECMO therapy.