The role of the perfusionist in the extracorporeal life support management: An international survey

Background Extracorporeal Life Support (ECLS) services are characterised by variability in resource availability, specific expertise, device management and team organisation, especially regarding the role of perfusionists. This international survey aimed to investigate perfusionists’ education, training and role within the ECLS team. Methods This is a descriptive, self-reporting, cross-sectional, voluntary, confidential international survey addressed to professionals involved in ECLS management, including perfusionists. The survey was distributed from April to August 2025 through congress, newsletter and social media platforms. Results A total of 178 ECLS centres submitted completed surveys. Most centres provided both cardiac and respiratory support ( n = 153, 86%) for over 10 years ( n = 117, 65.2%). Perfusionists, mainly holding a bachelor’s degree ( n = 77, 47.5%), were reported to be responsible for ECLS device in 87.1% ( n = 155) of centres, including priming ( n = 156, 87.6%), setting management ( n = 123, 69.1%), circuit/membrane lung replacement ( n = 151, 84%) and running the emergency hand-crank ( n = 133, 74.7%); though roles were often shared with multidisciplinary teams. Perfusionists were reported as part of retrievals/transports teams by 81.5% ( n = 145) of responders. Education practices were reported as heterogeneous, with limited periodic ECLS-specific training programs (monthly: n = 19, 10.7%; every 6 months: n = 48, 27%; yearly: n = 31, 17.4%; no continuous education provided: n = 55, 30.9%). Conclusions This international survey revealed marked variability in perfusionist education, training and roles within the ECLS teams, and related organization. Despite their technical responsibilities, a growing multidisciplinary collaboration is reshaping team dynamics. The absence of a standardized education remains a critical gap, requiring appropriate actions and planning by professional and scientific societies.