ELSO guidelines development: A roadmap

Area of Science:

• Critical Care Medicine
• Medical Guidelines
• Healthcare Policy

Background:

• The Extracorporeal Life Support Organization (ELSO) has evolved its guideline framework to address the growing demands of modern extracorporeal life support.
• ELSO has supported Extracorporporeal Membrane Oxygenation (ECMO) programs globally since 1989 through education and consensus-building.
• Increased ECMO utilization and evidence necessitate a more structured, transparent, and internationally representative approach to guideline development.

Purpose of the Study:

• To summarize the current ELSO guideline development process.
• To highlight recently published guidelines on critical ECMO topics.
• To outline the formal guideline update cycle and future directions.

Main Methods:

• Expansion of the Guideline Subcommittee (GSC) in 2023 to include all ELSO chapters and key disciplines.
• Implementation of a standardized workflow: proposal submission, methodological review, peer review, and approval.
• Integration of available evidence with multidisciplinary expert input for guideline creation.

Main Results:

• Four new guidelines published: early mobility, adult neuromonitoring, ECMO in pregnancy/peripartum, and accidental hypothermia.
• Guidelines provide globally applicable, practical recommendations for ECMO clinicians.
• Formalized update cycle and expanding international collaborations for joint guidance.

Conclusions:

• ELSO is committed to advancing high-quality, accessible guidelines for consistent ECMO care standards.
• Future priorities include guidelines for CPR, trauma, and enhanced global education.
• The updated process ensures methodological rigor, consistency, and timely production of ELSO guidelines.