ECMO Black Book

The operational framework for building a high-performance ECMO program. Written from the bedside out.

Most ECMO education teaches individuals how to manage a circuit. This book teaches you how to build the system that makes every run successful — regardless of who is on shift.

The ECMO Program Blueprint 2026 is an 11-chapter clinical reference covering everything from physiology and governance to cannulation, anticoagulation, complications, and emergencies. It is designed for program directors building a service line and bedside specialists who want to understand the whole picture — not just their piece of it.

What's inside:

— ECMO physiology and gas exchange principles — the foundation everything else builds on

— Program governance, staffing models, and the ECMO coordinator role — how high-performance programs are actually structured

— Patient selection using the Elevator Evaluation Framework — GO, PAUSE, STOP — and why most programs get this wrong

— Activation from decision to flow — how the best programs achieve consistently short door-to-flow times

— Cannulation strategy, procedural execution, and first-hour stabilization

— Anticoagulation and bleeding management — UFH, anti-Xa monitoring, heparin resistance, HIT, viscoelastic testing

— Circuit management and troubleshooting — pressure interpretation, TMPG trending, oxygenator assessment

— Complications and rescue scenarios — LV distension, Harlequin syndrome, hemolysis, limb ischemia, neurological events

— ICU management — sedation, awake ECMO, nutrition, ventilator strategy on support

— Weaning and liberation — sweep gas trials, flow trials, decannulation

— High-stakes emergencies and simulation — accidental decannulation, air embolism, pump failure, massive hemorrhage

— Interprofessional pearls — the human and team infrastructure that technology cannot replace

Format: Full clinical manuscript with visual atlas pages and Key Operational Points sections. Built for protocol development, program education, and expert-level reference.

Who it's for: Perfusionists, ECMO coordinators, critical care physicians, cardiac surgeons, nurses, and respiratory therapists involved in ECMO program development or management.

Central Coast Perfusion LLC · Tom Ferry, BS, CCP · ECMO Program Blueprint 2026 Series