Core components of transitional care for ECMO survivors after ICU discharge: a three-round modified Delphi study.

Authors

Paulo Costa, Amélia Ferreira

Published in

Heart & lung : the journal of critical care. Volume 80. Pages 102949. Sep 12, 2026. Epub Sep 12, 2026.

Abstract

Survivors of extracorporeal membrane oxygenation (ECMO) may experience persistent physical, cognitive, psychological, social, and quality-of-life impairments after intensive care unit (ICU) discharge. However, the core components of early transitional care after ECMO remain insufficiently defined.
To identify clinician-derived core components of an early transitional care framework for adult ECMO survivors after ICU discharge in Portugal.
We conducted a three-round modified Delphi consensus study with clinicians from the three Portuguese ECMO referral centers. Candidate items were informed by a scoping review, a cross-sectional study of national follow-up practices, and synthesis by the steering group. Panellists rated the importance of each item for inclusion in an early transitional care framework using a 5-point scale. Consensus was predefined as ≥70% of panellists rating an item as 5. Non-consensual items were revised or excluded based on quantitative feedback and qualitative comments.
Nine experts completed all three rounds. The final framework included 19 consensual components across four domains: objectives of care, clinical assessment and instruments, structure and timing of care delivery, and professional involvement. The framework supports early, staged follow-up beginning during ICU stay, continuing at ICU discharge, and extending into the first month after ICU discharge.
This study provides an initial clinician-derived consensus framework for early transitional care after ECMO in Portugal. The framework should not be interpreted as a definitive survivorship model. Further work should include survivors, caregivers, and broader multidisciplinary stakeholders, and should evaluate implementation, feasibility, and longer-term follow-up beyond the first month.

PMID:
42731577
Bibliographic data and abstract were imported from PubMed on 13 Sep 2026.

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