About the ECLS Center Certification

ELSO's ECLS Center Certification program establishes a standard for ECLS programs. It is designed to be informative for programs everywhere, while also providing structure and purpose for organizational help on a global scale. The program addresses key components that ELSO views essential: ECLS team education and training, policies and procedures, governance, financial management, and research for all institutions aiming to provide safe and accessible ECLS care.

The ECLS Center Certification is designed to recognize high-quality practice, policy, and program development in Extracorporeal Life Support (ECLS) care. ECLS care includes Extracorporeal Membrane Oxygenation (ECMO), Extracorporeal Carbon Dioxide Removal (ECCO2R), Extracorporeal Cardiopulmonary Resuscitation (ECPR), Extracorporeal Interval Support for Organ Retrieval (EISOR), and other forms of life support that utilize an artificial organ to support the patient. While the ELSO Center Certification program will evaluate all forms of ECLS, the focus of this program is ECMO - the most predominant form of ECLS currently provided.

The ECLS Center Certification will recognize ECLS centers by Patient Population, ECLS Support Type, and ECLS Certification Level. Applicant centers will designate their desired Patient Population and ECLS Support Type. The Center's Level will be designated by ELSO as part of the Application and Site Visit.

Patient Population

The patient population designations are as follows:

• ELSO Neonatal ELCS Center Certification designates active ECLS programs who treat patients from birth through 28 days of life.
• ELSO Pediatric ECLS Center Certification designates active ECLS programs who treat patients from 29 days of life through 18 years of age. Some Pediatric ECLS programs will treat patients up to 21 years of age.
• ELSO Adult ECLS Center Certification designates active ECLS programs who treat patients aged 18 years and older.

ECLS Support Type

• Cardiac ECLSM designates centers that provide ECLS for cardiac indications, including - but not limited to - cardiogenic shock, post-cardiac arrest recovery, post-cardiotomy recovery, cardiac failure, and infection-related cardiac conditions. Other cardiac indications may be provided.
• Respiratory ECLS designates centers that provide ECLS for respiratory indications, including - but not limited to - acute respiratory distress syndrome (ARDS), bacterial or viral infection, drowning, embolism, and hypoxic respiratory failure. Other respiratory indications may be provided.
• ECPR Designation indicates that a certified center has all resources necessary to fully support patients in in-hospital cardiac arrest (IHCA) and out-of-hospital cardiac arrest (OHCA) situations. These services will be available in-house with established service partnerships. OHCA cannulation in the field is not required for ECPR Designation.

ECLS Certification Level

Centers who achieve ECLS Center Certification will be awarded one of three (3) designations by ELSO:

• Level 1 designates ECLS centers that can provide all modes of cardiopulmonary support at all times. Level 1 Centers must have full ECLS transport capabilities and active heart and lung transplant programs - or demonstrate seamless access to them. * Level 1 Centers must always be open to ECLS consults.
• Level 2 designates centers that are capable of initiating and managing long-term ECLS management. Level 2 Centers will accept outside hospital transfers but may also transfer some patients to another facility for advanced treatment. May have some component of ECLS transport and/or heart & lung transplantation.
• Level 3 designates cannulation-only facilities and/or those that manage ECLS patients for a brief period. Level 3 Centers are primarily transferring their patients to a Level 1 or 2 Certified Center (or equivalent facility) for extended management.

*Strong partnership and/or contractual agreement with an external service provider(s) can satisfy the ECLS transport and/or heart & lung transplant requirement. This determination will be made as part of the application review and site visit.

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