The Agency for Clinical Innovation Best Practice Guidelines for NSW ECMO Services are recommendations from the expert group for Adult and Paediatric ECMO.
They represent best practice for models of care and clinical ECMO practice in NSW.
They are available here:
Adult patients
The clinical practice guide outlines key areas of ECMO practice for adult patients in NSW: indications and patient selection, retrieval, initiation, maintenance, weaning, complications, use in extra corporeal pulmonary, resuscitation.
Published: November 2020. Next review: 2026.
The adult ECMO model of care is based on five core principles: structure and organisation, protocols and procedures, appropriate team composition, workforce education and training, and governance and leadership.
Published: November 2020. Next review: 2026.
This guide aims to standardise care, reduce variation and improve outcomes for patients across NSW. It is for all clinicians involved in recognising and managing cardiogenic shock, including professionals in cardiology, emergency medicine, intensive care, anaesthesia, cardiothoracic surgery and retrieval.
Published: April 2026. Next review: 2031.
Neonatal and paediatric patients
Drawing on experiential and research evidence, this report outlines the neonatal and paediatric ECMO retrieval services in NSW.
Published: November 2020. Next review: 2026.
The organisational model of care for neonatal and paediatric ECMO retrievals focuses on eight key components: operationalising retrievals, communication and decision making, checklists and protocols, team composition, data and information, education and training, governance and patient, family and carer support.
Published: November 2020. Next review: 2026.
This guide outlines equipment components for an ECMO retrieval service: equipment components for a child requiring ECMO, additional equipment required from a referring hospital, a checklist for instruments and equipment, equipment for site cannulation.
Published: February 2022. Next review: 2026.
Evidence-Based Guidelines for the Use of Extracorporeal Membrane Oxygenation in Australia and New Zealand Aotearoa
This evidence-based guideline for V-V ECMO by Newman, et al. is the first in a series of nationally developed, evidence-based recommendations for extracorporeal life support, using a rigorous GRADE methodology. It provides practical guidance on patient selection, timing, and management of V-V ECMO in adult respiratory failure, with a focus on severe ARDS. The guideline supports the use of V-V ECMO as a conditional recommendation in carefully selected patients after failure of optimal conventional therapy, while highlighting important uncertainties around long-term outcomes, ventilation strategies, and patient subgroups. It also emphasises the complexity, resource implications, and need for system-level coordination in delivering high-quality ECMO care.
Published: Mar 2026.
