Extracorporeal Life Support Organization

The Extracorporeal Life Support Organization, commonly known as ELSO, is an international nonprofit professional organization established in 1989 to support clinicians, scientists, hospitals, and other specialists involved in extracorporeal membrane oxygenation and related forms of extracorporeal life support. Rather than operating as a medical-device manufacturer or a hospital network, ELSO functions as a standards, education, registry, research-support, and professional-coordination body for a highly specialized area of critical care. A central part of ELSO's work is its registry of extracorporeal life-support activity. The registry records patient characteristics, treatment details, complications, and outcomes reported by participating centers. Over time, the system developed from paper-based documentation into a web-enabled database with structured definitions, data-entry warnings, and record validation procedures. The resulting data support clinical research, benchmarking, quality improvement, regulatory and policy work, and the development of more consistent ECMO practice. ELSO also provides registry information and services to individual member centers seeking to assess their programs. The organization supports facilities that provide ECMO as well as institutions that may need to stabilize and transfer patients to advanced centers. Its educational activities include programs for active ECMO centers, guidance for establishing and managing ECMO services, training resources for ECMO specialists, textbooks, manuals, and materials addressing patient selection, equipment, staffing, and care processes. ELSO guidance covers multiple clinical settings, including neonatal respiratory failure, adult respiratory failure, pediatric cardiac support, mechanical circulatory support, post-cardiac-arrest care, and other specialized uses of extracorporeal support. ELSO has expanded its international reach through regional chapters. Euro-ELSO was founded in 2011, followed by Asia-Pacific ELSO and Latin American ELSO in 2012, and South and West Asia and Africa ELSO in 2013. These chapters are intended to address regional practice, education, organization, and networking needs while remaining connected to the broader ELSO community. The organization also recognizes high-performing programs through its Award for Excellence in Life Support, which assesses program systems, processes, and outcomes. The ELSO registry became particularly visible during the COVID-19 pandemic, when the organization began collecting and publishing information about ECMO use for patients with COVID-19. This reporting provided an international view of treatment activity and outcomes during a rapidly changing public-health emergency. A 2020 analysis of more than one thousand COVID-19 patients supported at experienced centers in multiple countries reported mortality comparable to that observed in other severe respiratory illnesses treated with ECMO. ELSO's pandemic role illustrated how a professional registry can support near-real-time clinical situational awareness while also generating material for later research. ELSO's broader positioning is that of a global infrastructure organization for extracorporeal life support. Its influence comes from convening specialized professionals, maintaining a large longitudinal dataset, publishing guidelines and position statements, supporting training, and encouraging quality standards among ECMO centers. The organization does not replace local medical regulation or clinical judgment; its materials are intended to inform programs and practitioners working within their own institutional and national frameworks.

ELSO was established in 1989 as a nonprofit organization serving the emerging international community of professionals involved in extracorporeal life support. Its initial and continuing focus has been ECMO, a form of temporary mechanical support that can provide oxygenation, carbon-dioxide removal, and circulatory assistance when conventional treatment is insufficient. The organization developed as a coordinating and knowledge-sharing body for physicians, nurses, respiratory therapists, perfusionists, researchers, program administrators, and other specialists. From its early years, ELSO maintained a registry containing clinical information on patients supported with ECMO. The registry's purpose expanded beyond recordkeeping: its data could be used to study outcomes, identify complications, compare program performance, inform regulatory and policy discussions, and help individual centers improve their services. The registry evolved from paper records into a structured electronic and web-based system. Definitions, automated warnings, and validation checks were introduced to improve consistency and completeness across participating centers. ELSO also developed an education and guidance role. It publishes recommendations for organizing ECMO programs, selecting and maintaining equipment, staffing services, and managing patients in different clinical situations. Its subject areas include neonatal respiratory failure, adult acute respiratory failure, pediatric cardiac support, mechanical circulatory support, post-cardiac-arrest care, and other applications. Position statements and consensus documents address topics such as the role of intensivists, terminology and cannulation configurations, global ECMO education, and the use of ECMO in infectious diseases and other high-risk conditions. Training resources include textbooks, manuals, and programs for professionals who work directly with ECMO patients or support the transfer of patients to specialized centers. As ECMO use spread internationally, ELSO created regional chapters to represent local needs. Euro-ELSO was founded in 2011. Asia-Pacific ELSO and Latin American ELSO followed in 2012, while South and West Asia and Africa ELSO was established in 2013. The chapter structure enabled regional education, networking, and professional development while preserving a common connection to ELSO's international registry and standards activities. The organization has also promoted quality recognition. Its Award for Excellence in Life Support acknowledges centers with strong programs, systems, processes, and reported outcomes. This reflects ELSO's emphasis on ECMO as a complex service that depends not only on technology but also on multidisciplinary staffing, protocols, training, quality management, and the ability to coordinate referrals and transfers. The COVID-19 pandemic marked a significant development in ELSO's registry and public-information work. In response to worldwide demand for information about ECMO in severe COVID-19, the registry began collecting relevant cases and publishing updates. A 2020 international study based on 1,035 patients treated at 213 experienced centers in 36 countries reported 38 percent mortality. The study and associated reporting demonstrated the value of a multinational registry for describing practice during a rapidly evolving emergency, although the data remained observational and dependent on reports from participating centers. Today, ELSO is best understood as professional and clinical infrastructure for extracorporeal life support rather than as a conventional commercial brand. Its principal activities are maintaining a specialized registry, supporting research and quality improvement, publishing guidance and position statements, educating ECMO teams, connecting regional communities, and recognizing high-quality programs.

1. 2020Registry reaches more than 129,000 patients

   At the beginning of 2020, the registry contained data on 129,037 patients from 435 member centers worldwide.

   Source
2. 2020COVID-19 ECMO reporting begins

   ELSO adds COVID-19-related ECMO data collection and begins reporting international use and outcomes during the pandemic.

   Source
3. 2017Registry report covers 78,397 ECMO patients

   The last formally published registry report cited in the reference material describes the characteristics, complications, and outcomes of 78,397 supported patients.

   Source
4. 2013South and West Asia and Africa chapter is formed

   A regional chapter is established to represent ECMO interests and professional needs in South and West Asia and Africa.

   Source
5. 2012Asia-Pacific and Latin American chapters are formed

   ELSO expands its regional structure with chapters serving Asia-Pacific and Central and South America.

   Source
6. 2011Euro-ELSO is founded

   A European regional chapter is created to address the needs of ECMO professionals and centers in Europe.

   Source
7. 1989ELSO is established

   The nonprofit organization is founded to support healthcare professionals and scientists working with extracorporeal life support and ECMO.

   Source

A global nonprofit standards, registry, education, and quality-improvement organization for extracorporeal membrane oxygenation and related life-support services.

• ELSO RegistryClinical registry and research infrastructure1989

  A multinational database containing clinical characteristics, treatment information, complications, and outcomes for patients receiving ECMO and related extracorporeal support. Participating centers enter records using standardized definitions and validation processes. The registry supports research, benchmarking, quality improvement, regulatory work, and center-level program review. During the COVID-19 pandemic, it was expanded to capture and report information about ECMO use in infected patients.

• ECMO Care GuidelinesClinical standards and guidance

  Guidance covering the organization of ECMO programs, equipment, staffing, and patient management. The materials address different patient populations and clinical indications, including neonatal respiratory failure, adult respiratory failure, and pediatric cardiac support. They are intended to help centers establish consistent systems and processes while remaining subject to local clinical and regulatory requirements.

• ELSO Education ProgramsProfessional education and training

  Educational programs, textbooks, manuals, and training resources for clinicians and other professionals involved in ECMO. The materials support active ECMO centers and facilities that may need to recognize, stabilize, or transfer patients to higher levels of care. Relevant professional backgrounds include respiratory therapy, critical-care nursing, and clinical perfusion.

• Award for Excellence in Life SupportQuality recognition

  A recognition program for ECMO centers demonstrating exceptional systems, processes, programs, and outcomes. The award reflects ELSO's emphasis on multidisciplinary organization and quality management in addition to technical capacity.

• 2020COVID-19 ECMO Registry Initiative

  Global

  ELSO adapted its registry to collect international information on ECMO treatment for patients with COVID-19 and published updates during the pandemic.

  Outcome. The initiative produced multinational observational data and supported a published analysis of 1,035 patients treated at 213 experienced centers in 36 countries.

  Source

• 2020Expand registry activity for COVID-19 casesStrategy

  The COVID-19 pandemic created an urgent need for international information about the use and outcomes of ECMO in severe disease.

  What changed. ELSO began collecting COVID-19-specific ECMO data and reporting information through its registry and website.

  Aftermath. The effort generated international observational evidence, including a 2020 study of 1,035 patients from 213 centers in 36 countries.

  Source

• 2020ELSO registry expands during the COVID-19 pandemic

  ELSO began collecting and reporting international data on ECMO use in patients with COVID-19, making the registry a source of rapidly updated information during the pandemic.

  Other
  Source
• 2020International study reports outcomes for COVID-19 patients receiving ECMO

  An analysis of 1,035 COVID-19 patients treated at 213 experienced ECMO centers in 36 countries reported a mortality rate of 38 percent.

  Other
  Source

1. Extracorporeal Life Support Organization
2. Extracorporeal Life Support Organization official website