Expert consensus on training and accreditation for extracorporeal cardiopulmonary resuscitation an international, multidisciplinary modified Delphi Study.

Background: A multidisciplinary group of stakeholders were used to identify: (1) the core competencies of a training program required to perform in-hospital ECPR initiation (2) additional competencies required to perform pre-hospital ECPR initiation and; (3) the optimal training method and maintenance protocol for delivering an ECPR program.
Methods: A modified Delphi process was undertaken utilising two web based survey rounds and one virtual meeting. Experts rated the importance of different aspects of ECPR training, competency and governance on a 9-point Likert scale. A diverse, representative group was targeted. Consensus was achieved when greater than 70% respondents rated a domain as critical (> or = 7 on the 9 point Likert scale).
Results: 35 international ECPR experts from 9 countries formed the expert panel, with a median number of 14 years of ECMO practice (interquartile range 11-38). Participant response rates were 97% (survey round one), 63% (virtual meeting) and 100% (survey round two). After the second round of the survey, 47 consensus statements were formed outlining a core set of competencies required for ECPR provision. We identified key elements required to safely train and perform ECPR including skill pre-requisites, surrogate skill identification, the importance of competency-based assessment over volume of practice and competency requirements for successful ECPR practice and skill maintenance.
Conclusions: We present a series of core competencies, training requirements and ongoing governance protocols to guide safe ECPR implementation. These findings can be used to develop training syllabus and guide minimum standards for competency as the growth of ECPR practitioners continues.
Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [Dirk W. Donker is involved in institutional research consultancy to Getinge – Maquet Critical Care AB, Solna, Sweden; institutional research cooperation with Sonion BV, Hoofddorp, The Netherlands; and consultancy to HBOX Therapies GmbH, Aachen, Germany; all fees and financial compensation paid to the University of Twente, no personal fees received. Demetris Yannopoulos has received NIH grants to study ECPR, philanthropic grants to establish ECPR in Minneapolis ST Paul and has received speaker's honoraria from Medtronic Corporation and Getinge to discuss ECPR. Lionel Lamhaut is the president of SAUV life (non profit organization). Drs Kruit, Burrell and Dennis conceived of the study. All authors contributed to the study with data acquisition and interpretation. All authors reviewed and revised the manuscript. All authors approved the final version of the manuscript. All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted].
(Copyright © 2023 Elsevier B.V. All rights reserved.)