Abstract
Background
Extracorporeal membrane oxygenation (ECMO) is an essential life-support modality for children with severe cardiac and respiratory failure. Although its global use has expanded, ECMO remains resource-intensive, requiring specialized training, multidisciplinary support, and institutional infrastructure.
Objective
To assess pediatric intensivists’ knowledge, practice patterns, and perceptions regarding ECMO in Saudi Arabia and the Gulf region, and to identify barriers to ECMO implementation and training.
Methods
A cross-sectional survey using a validated, self-administered electronic questionnaire was distributed to pediatric intensivists in Saudi Arabia and Gulf countries. The survey assessed demographics, ECMO knowledge, clinical practice patterns, and perceived barriers.
Results
A total of 151 intensivists responded; 74.2% were male, and 61.6% had ≥11 years of clinical experience. ECMO services were available in 42.4% of institutions, predominantly in pediatric cardiac ICUs (82.8%). Perfusionist support was reported in 53.6% of centers. ECMO circuits were primarily managed by perfusionists (98.5%), and cannulation was mainly performed by cardiac surgeons (87.5%). Knowledge scores were generally low, with only 9.9% scoring 60–80%. Major barriers included inadequate training of medical (68%) and nursing staff (72%), lack of ECMO availability (60%), and limited cardiothoracic surgical support (56%). Higher knowledge scores were observed among respondents from ECMO-capable centers or those with prior ECMO training (p < 0.01). Only 25.3% reported having an ECMO transfer protocol.
Conclusions
Significant gaps in ECMO knowledge and training exist among pediatric intensivists in the Gulf region. Structured education programs, standardized practices, and enhanced multidisciplinary support are urgently needed to improve ECMO readiness and outcomes.
Keywords
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