Round 1 | Round 2 | |||||||||||||
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KNOWLEDGE | Mean (SD) | Median [IQR] | Consensus % | Mean (SD) | Median [IQR] | Consensus % | ||||||||
CONSENSUS | ||||||||||||||
Round 1: Knowledge of ECMO physiology: in VA-ECMO: Optimization of hemodynamic support Round 2: Knowledge of ECMO physiology: in VA-ECMO: Optimization of hemodynamic support, including blood flow and native cardiac function | 4.65 (0.7) | 5.0 [4.0–5.0] | 96.55 | 4.79 (0.41) | 5.0 [5.0–5.0] | 100 | ||||||||
Round 1 & 2: Knowledge of ECMO physiology: Optimization of pCO2. | 4.56 (0.62) | 5.0 [4.0–5.0] | 89.66 | 4.75 (0.44) | 5.0 [4.25-5.0] | 100 | ||||||||
Round 1 & 2: Knowledge of symptoms and clinical signs of limb ischemia and prevention of it. | 4.73 (0.45) | 5.0 [4.0–5.0] | 100 | 4.72 (0.53) | 5.0 [4.0–5.0] | 96.55 | ||||||||
NO CONSENSUS | ||||||||||||||
Round 1: Knowledge of pre-ECMO evaluation including RESP-score and SAVE-score (RESP = Respiratory Extracorporeal membrane Oxygenation Survival Prediction, SAVE = Survival After V-A ECMO). Round 2: For the physician, knowledge of pre-ECMO evaluation including RESP-score and SAVE-score (RESP = Respiratory Extracorporeal membrane Oxygenation Survival Prediction, SAVE = Survival After V-A ECMO). | 3.80 (0.69) | 4.0 [4.0–4.0] | 77.1 | 3.95 (0.75) | 4.0 [4.0–4.0] | 79.3 | ||||||||
Round 1: Knowledge of the principles of ECMO nomenclature. Round 2: Knowledge of correct ECMO nomenclature. | 4.00 (0.72) | 5.0 [3.5-5.0] | 74.5 | 3.90 (0.64) | 4.0 [3.25-4.0] | 71.4 | ||||||||
Round 1 | Round 2 | |||||||||||||
TECHNICAL SKILLS | Mean (SD) | Median [IQR] | Consensus % | Mean (SD) | Median [IQR] | Consensus % | ||||||||
CONSENSUS | ||||||||||||||
Round 1: Being able to change the oxygenator Round 2: For perfusionist: being able to change the circuit / oxygenator. | 3.80 (1.22) | 4.0 [3.0–5.0] | 66.67 | 4.76 (0.44) | 5.0 [4.5-5.0] | 100 | ||||||||
Round 1: Being able to prime the circuit Round 2: For the perfusionist: being able to prime the circuit. | 3.66 (1.1) | 4.0 [3.0–5.0] | 60.71 | 4.72 (0.45) | 5.0 [4.0–5.0] | 100 | ||||||||
Round 1: Being able to insert / connect the cannulas correct. Round 2: For the physician and perfusionist: being able to insert / connect the cannulas correct. | 4.28 (0.93) | 5.0 [4.0–5.0] | 82.14 | 4.61 (0.69) | 5.0 [4.0–5.0] | 96.43 | ||||||||
NO CONSENSUS | ||||||||||||||
Round 1: For the physician: being able to measure the vessel diameter and perform ultrasound guided puncture in peripheral ECMO. Round 2: For the physician: being able to measure the vessel diameter and perform ultrasound guided puncture in peripheral ECMO. | 3.70 (1.08) | 4.0 [3.0–5.0] | 57.4 | 4.0 (0.97) | 4.0 [3.0–5.0] | 72.4 | ||||||||
Round 1 | Round 2 | |||||||||||||
ATTITUDE | Mean (SD) | Median [IQR] | Consensus % | Mean (SD) | Median [IQR] | Consensus % | ||||||||
CONSENSUS | ||||||||||||||
Round 1 & 2: Knowledge of his/her limits and call for help if needed. | 4.79 (0.46) | 5.0 [5.0–5.0] | 96.43 | 4.82 (0.35) | 5.0 [5.0–5.0] | 100 | ||||||||
Round 1 & 2: There should be an experienced team available 24/24 7/7 for troubleshooting. | 4.77 (0.42) | 5.0 [5.0–5.0] | 100 | 4.76 (0.51) | 5.0 [5.0–5.0] | 96.55 | ||||||||
Round 1 & 2: Be able to consider the risks/ benefits for every ECMO run. | 4.54 (0.54) | 5.0 [4.0–5.0] | 100 | 4.62 (0.49) | 5.0 [4.0–5.0] | 100 | ||||||||
NO CONSENSUS | ||||||||||||||
Round 1: To obtain an informed consent from the patient or family. Round 2: The physician should obtain an informed consent from the patient or family. | 3.95 (0.88) | 4.0 [3.0-4.5] | 63.0 | 3.80 (0.89) | 4.0 [3.0–4.0] | 63.0 | ||||||||
Round 1 & 2: Handovers and communication should be structured and standardized e.g., using ISBAR. | 4.15 (081) | 4.0 [3.25-5] | 73.3 | 3.95 (0.60) | 4.0 [4.0–4.0] | 75.9 | ||||||||
Round 1: Being an ELSO-member (Extracorporeal Life Support Organization) Round 2: The center should be registered as an ELSO-member (Extracorporeal Life Support Organization) | 3.80 (0.89) | 4.0 [3.0–5.0] | 70.2 | 4.05 (0.68) | 4.0 [4.0-4.75] | 75.9 |