Nursing management in extracorporeal membrane oxygenation (ECMO): A scoping review

Objectives: 

To synthesise the existing literature on nursing management in the care of ECMO-supported patients, with a focus on: (1) the competencies required for ECMO nursing care, (2) the roles and responsibilities of ICU nurses, and (3) contextual factors shaping nursing practice. 

Methods: 

This scoping review followed the Joanna Briggs Institute methodology for scoping reviews and was guided by the Population–Concept–Context framework to structure the review question and scope. A systematic literature search was conducted in January 2026 across MEDLINE, Embase, Web of Science, CINAHL, Scopus, and Google Scholar. Study characteristics were summarised descriptively, and a thematic analysis was undertaken to synthesise key elements of nursing management in ECMO care. 

Findings: 

A total of 1766 records were identified, and 18 were included in the review. The synthesis process identified four overarching themes relevant for competent ECMO nursing management: (1) required knowledge for ECMO nursing care, (2) clinical and non-technical skills, (3) professional attitudes and behaviour, and (4) roles and responsibilities of ICU nurses providing ECMO care. In addition, several contextual challenges and enablers were identified that influence ICU nurses’ ability to deliver daily ECMO care, including workload, staffing models, training opportunities, and organisational support. 

Conclusions: 

Nursing management in ECMO care is inherently complex and context-dependent, in which technical and non-technical competencies, professional attitudes, and responsibility-taking are closely intertwined. While ICU nurses play a central role throughout all phases of ECMO care, the delivery of competent care is strongly shaped by organisational and contextual conditions. 

Implications for Clinical Practice: 

The identified competencies offer guidance for structuring ECMO-specific training programmes, defining professional roles and responsibilities, and supporting safe and consistent nursing practice. Reported challenges and enablers highlight key organisational, educational, and workforce-related factors that should be addressed to optimise the clinical implementation of ECMO nursing care.