[Expert consensus on analgesia, sedation and delirium management in adult patients receiving extracorporeal membrane oxygenation(2025 edition)].

Pain management, sedation, and delirium control are critical components in managing adult patients receiving extracorporeal membrane oxygenation (ECMO). Appropriate management of these interventions is essential for mitigating pain-induced stress, maintaining patient-ventilator synchrony, and reducing complications. However, as an extracorporeal life support technology, ECMO may significantly alter the pharmacokinetics and pharmacodynamics of analgesics and sedatives through mechanisms such as drug adsorption and an increased volume of distribution. Additionally, the complex pathophysiological status of ECMO patients, including multi-organ dysfunction and exacerbated inflammatory responses, further amplifies challenges in analgesia, sedation, and delirium management. Currently, there are no specific guidelines addressing ECMO patients globally, resulting in substantial heterogeneity and uncertainty in clinical practice. To address this gap, the Extracorporeal Life Support Professional Committee of the Chinese Medical Doctor Association and Chinese Society of Anesthesiology developed this expert consensus based on evidence-based principles. Through systematic literature analysis and a modified Delphi method for expert opinion aggregation, 15 key clinical questions were refined, culminating in 25 evidence-based recommendations. This consensus aims to standardize analgesia-sedation strategies, optimize delirium management protocols, and provide a scientific, consistent framework for clinical practice to improve patient outcomes.