ECMO & CVOR: Specialized Training for Specific Needs

Cardiovascular care involves many acronyms. Two important ones to know are ECMO (extracorporeal membrane oxygenation) and CVOR (cardiovascular operating room) — especially since AdventHealth Pepin Heart Institute’s elite ECMO and CVOR teams help improve outcomes every day for patients with severe heart and lung conditions.

Rozales Swanson, MD, a cardiovascular and thoracic surgeon and ECMO program director at Pepin Heart Institute at AdventHealth Tampa[NM1] [MS2] [MN3] [MS4] , and Clayton Johnson, ECMO coordinator at AdventHealth Tampa, share more about the specialized training and accreditations these teams earn so they can offer the highest level of care to our surrounding communities.

What is ECMO?

If you or a loved one has cardiac instability, such as after a heart attack, shock or cardiac arrest, your care team may recommend ECMO. This type of life support pumps deoxygenated blood out of your body and runs it through machines that add oxygen and pressurize it before pumping it back into you.

Starting and managing ECMO, however, is a complicated process that requires specialized training and tightly coordinated care with a heart and lung care team. AdventHealth Tampa’s team includes 17 cardiac nurses and two respiratory therapists, surgeons, and critical care physicians — all trained to care for these critically ill patients.

ECMO care continues to evolve to support patients. For example, AdventHealth Tampa implemented ECPR in Feb 2025, a new protocol that means seriously ill patients can receive ECMO if CPR has failed to resuscitate them. This program is already making an impact for patients: With the addition of ECPR, the odds of survival following CPR in the hospital are more than double.

“What’s most meaningful to me is knowing that the people who had a limited chance at survival , whose families had lost hope, now have that hope restored,” says Dr. Swanson. “ECMO gives them a chance to get better and walk out of the hospital.”

ECMO Specialist Training

ECMO providers, including nurses and respiratory therapists, go through specialized training that makes them uniquely qualified to care for their patients. There are three tiers of ECMO providers based on their training and experience:

• Level 1: Nurses and therapists complete an ECMO-specific training course, offered by AdventHealth Tampa, on what to expect with an ECMO patient. These nurses provide bedside care for patients on ECMO machines.
  
  Level 2: After completing the level 1 course and gaining bedside experience, practitioners can take a more detailed course with hands-on ECMO circuit training, respiratory and cardiac support, and documentation protocols. These nurses offer a more advanced level of care for ECMO patients.
  
  Level 3: While there is no formal training to move to level 3, level 2 nurses and therapists who have enough bedside hours and experience managing complex ECMO situations can gain their level 3 certification. These advanced specialists assist the CVOR team in more complicated care, such as starting the ECMO pump.

ECMO nurses and respiratory therapists are confirmed as Certified ECMO Specialists - Adult (CES-A®) through the International Board of Blood Management (IBBM) and the American Society of ExtraCorporeal Technology (AmSECT), or as ELSO Adult ECMO Certified Specialist (E-AEC) through the Extracorporeal Life Support Organization (ELSO).

End-to-End Cardiovascular Care

These dedicated care teams improve cardiovascular patient outcomes by offering coordinated care throughout the hospital, from the emergency department and the intensive care unit (ICU) to the CVOR and beyond.

“Most ECMO patients come through the CVOR, which means the ECMO and CVOR teams work hand in hand,” says Clayton. “Because of this, we offer a controlled environment with all the right specialists and equipment for this complex procedure.”

The CVOR team includes:

• Surgeons
• Anesthesia specialists
• Circulating nurses
• Radiologists
• Surgical techs

This group places access (surgically putting tubes into a patient’s blood vessels) and works together with the ECMO team to get patients on the pump.

“We offer a smooth transition from one end of the hospital to the other,” says Dr. Swanson. “With better care, the best personnel and state-of-the-art equipment, we avoid errors so patients are able to be discharged home .”

A Culture of Continuous Improvement

AdventHealth Tampa earned the Extracorporeal Life Support Organization (ELSO) Silver Center of Excellence recognition for its ECMO program, the highest level of award available for new programs. This voluntary accreditation is good for three years and was based on a thorough audit of the hospital and program by ELSO, the governing body.

“Accreditations are helpful for patients to look for to know their hospital is providing quality care,” says Clayton. “For us to achieve accreditation with a newer program is a huge feat that shows we’re dedicated to our patients and to quality improvement. That standard of outcomes builds trust with the community.”

Accreditation is just one step, though. The ECMO and CVOR teams conduct debriefs and case reviews for each ECMO patient to help improve the quality of care, especially with newer protocols like ECPR.

“These accreditations show that we care about our outcomes and quality control,” says Clayton. “We care about the patient and what’s best for them and, ultimately, we are working to improve our programs even more for our community.”

Leading Cardiovascular Care in Tampa

You deserve life-changing cardiovascular care from the providers who know your heart best. From ECMO specialists who help you recover from serious conditions to preventive care that keeps your heart going strong, Pepin Heart Institute at AdventHealth Tampa is here with the most advanced treatment for you. Learn more.