Kurt Strudwick, MS, is the National Clinical Educator – ECMO/ECLS for SpecialtyCare. As an accomplished ECMO Specialist, he worked at the Johns Hopkins Hospital where he focused his efforts on education and research. He also worked as an ECMO Coordinator at St. Christopher’s Hospital for Children. He has contributed to clinical publications focused on patient care and patient safety. Kurt is responsible for designing, implementing, evaluating, and revising academic and continuing education for all SpecialtyCare ECMO centers across the United States.

What is ECMO? 

Extracorporeal Membrane Oxygenation (ECMO) is a form of Extracorporeal Life Support (ECLS) offered to patients with severe reversible cardiac, pulmonary, or combined cardiopulmonary failure that is refractory to conventional medical treatment. ECMO is commonly used as a life-saving therapy in conditions such as cardiogenic shock or acute respiratory distress syndrome (ARDS) and provides support to the patient’s heart and lungs while allowing their organs to rest and recover or as a bridge to a transplant.  

What are the Different Types of ECMO? 

There are two common types of ECMO. Venoarterial (VA) ECMO is used to provide support for the patient’s heart and lungs by removing blood from a large vein and returning oxygenated blood into a large artery. This form of ECMO bypasses both the heart and the lungs and allows oxygen-rich blood to circulate through the body despite the compromised organs. Venovenous (VV) ECMO solely supports patients in the pulmonary failure, but the heart must be able to fully function to meet the body’s needs. With VV ECMO, deoxygenated blood is drained from a major vein, sent through the ECMO circuit, and oxygen-rich blood is returned to a major vein which is then pumped by the heart.

What are the Benefits of a Career in ECMO?  

The benefits include providing care and assistance to the sickest patients whose heart and lungs need additional time for rest and recovery. There is also a significant potential for professional growth and opportunities for continuous education in ECMO. 

What is an ECMO Specialist? 

According to the Extracorporeal Life Support Organization (ELSO), an ECMO Specialist is defined as “”the technical specialist trained to manage the ECMO system and the clinical needs of the patient on ECMO under the direction and supervision of a licensed ECMO trained  physician.” It is the expectation that an ECMO Specialist have a strong critical care background as a registered nurse (RN), registered respiratory therapist (RRT), or a certified cardiovascular perfusionist. 

How Do You Become an ECMO Specialist? 

There are various ways one can become an ECMO Specialist. I became an ECMO Specialist through an intensive in-house training program during my career at the Johns Hopkins Hospital in Baltimore, Maryland. Previously, I functioned as a registered respiratory therapist (RRT) in the pediatric cardiac intensive care unit (PCICU), the pediatric intensive care unit (PICU), and the neonatal intensive care unit (NICU). In this training, I was able to gain an advanced understanding in various areas such as mechanical circulatory support devices, hemodynamics, renal replacement therapies, anticoagulation, pathophysiology, and cardiopulmonary physiology,  patient/circuit management, and mitigation of emergencies. 

What is a Day in the Life of an ECMO Specialist Like?  

The day-to-day varies for an ECMO Specialist. Some of the significant responsibilities include assisting with setup and priming of the ECMO circuit, cannulation, initiation of support, decannulation/termination of ECMO support, formulating weaning strategies, transfusion/administration of blood products, management of anticoagulation and acid-base balance, emergencies, and advanced troubleshooting.  

How Does ECMO Change the Dynamic of the ICU? 

Teamwork and flexibility are critical factors to any successful program. ECMO patients are the sickest patients in the hospital, and they require a significant number of resources to care for them. Advances in the field of ECMO continue to grow rapidly and have the potential to put a strain on already stretched resources as some patients can ambulate while awake on ECMO.  

What Communication Advice Do You Have for the Team Dynamic of the ICU?

ECMO can be challenging and requires a skilled multidisciplinary approach to effective patient management and improved clinical outcomes. Successful outcomes are dependent on the technical skills and input from all members that are a part of the ICU/ECMO team.  

What is a Resource You Enjoy and Trust on the Profession?  

Extracorporeal Life Support: The ELSO Red Book.  

What Surprised You When You Began Your Career?

The biggest surprise for me was seeing the resilience of the human body. Seeing patients on the verge of death, being able to come off ECMO, leave the hospital, and live everyday lives was astounding. This was when I truly found my drive and motivation to enhance my career in ECMO.