Program Code: SCF-DBI-PECMO-0001
Integrated Platforms
- SCF-DBI Critical Care Medicine System
- SCF-PCR Framework
- Project RHENOVA
- Universal ICU Surveillance System
- ANMS Surveillance Engine
- Neurocardiac Intelligence Engine
- Neurovascular Intelligence Engine
- Regenerative Immunology Platform
- Recovery Intelligence Platform
- Pediatric Recovery Command Center
SECTION 1
PROGRAM MISSION
The Pediatric ECMO Center exists to:
- Preserve life during severe cardiopulmonary failure.
- Preserve neurologic viability.
- Preserve developmental biology.
- Preserve endothelial integrity.
- Preserve immune competence.
- Preserve recovery intelligence.
- Restore long-term pediatric functional potential.
SECTION 2
CLINICAL POSITIONING
Traditional ECMO Programs
Historically focus on:
- Cannulation
- Oxygenation
- Perfusion
- Survival
- Decannulation
SCF-DBI ECMO Programs
Focus on:
Survival
PLUS
Brain Preservation
PLUS
Developmental Preservation
PLUS
Endothelial Preservation
PLUS
Recovery Preservation
PLUS
Long-Term Functional Recovery
SECTION 3
ECMO CENTER ORGANIZATIONAL STRUCTURE
Medical Leadership
ECMO Medical Director
Responsibilities:
- Program oversight
- Clinical governance
- Rescue activation authority
- Quality management
Associate Directors
Cardiology
Cardiac Surgery
Critical Care
Neurology
Transplant Medicine
Operational Leadership
ECMO Program Manager
ECMO Coordinator
ECMO Education Director
ECMO Data Manager
ECMO Quality Officer
SECTION 4
ECMO CENTER SERVICE LINES
Service Line 1
Cardiac ECMO
Indications:
- Cardiogenic shock
- LCOS
- Myocarditis
- Cardiomyopathy
- Postoperative failure
Service Line 2
Respiratory ECMO
Indications:
- Severe ARDS
- Pulmonary hypertension
- Respiratory failure
Service Line 3
ECPR Program
Indications:
- Cardiac arrest
- Refractory CPR
- Shock collapse
Service Line 4
Transplant ECMO
Indications:
- Primary graft dysfunction
- Rejection-associated collapse
- Bridge-to-transplant
Service Line 5
Neonatal ECMO
Indications:
- PPHN
- Meconium aspiration
- Congenital diaphragmatic hernia
- Severe neonatal respiratory failure
SECTION 5
SCF-DBI ECMO PHILOSOPHY
ECMO Defined As
Biological Intelligence Preservation Technology
rather than
Mechanical Support Technology
Primary Preservation Domains
Domain 1
Neuroprotection
Domain 2
Endothelial Protection
Domain 3
Immune Preservation
Domain 4
Developmental Preservation
Domain 5
Recovery Preservation
SECTION 6
ECMO CENTER COMMAND CENTER
Core Systems
ECMO Surveillance Console
ANMS Console
Recovery Intelligence Console
Neurocritical Care Console
Infection Surveillance Console
ECMO Quality Dashboard
Real-Time Outputs
ECMO Failure Risk
Circuit Failure Risk
Neurologic Risk
Recovery Delay Risk
Endothelial Collapse Risk
Infection Risk
SECTION 7
ECMO ACTIVATION SYSTEM
Activation Level 1
ECMO Consultation
Examples:
- Progressive shock
- Worsening oxygenation
Activation Level 2
ECMO Alert
Examples:
- Escalating vasoactive support
- Rising lactate
Activation Level 3
ECMO Standby
Examples:
- Impending collapse
- ECPR candidate
Activation Level 4
Cannulation Activation
Examples:
- Refractory shock
- Severe respiratory failure
SECTION 8
ECMO PATIENT CLASSIFICATION SYSTEM
Class I
Bridge-to-Recovery
Expected recovery likely
Class II
Bridge-to-Decision
Recovery uncertain
Class III
Bridge-to-Transplant
Recovery unlikely
Class IV
Bridge-to-VAD
Long-term support anticipated
Class V
Bridge-to-Regeneration
Advanced regenerative therapies planned
(Project RHENOVA Integration)
SECTION 9
ECMO CLINICAL INTELLIGENCE DOMAINS
Neurocardiac Intelligence
NCRS
Endothelial Intelligence
EII
Neuroimmune Intelligence
STRI
Cerebral Adaptation Intelligence
CAI
Recovery Intelligence
CRIS
Global Intelligence
ANMS
SECTION 10
ECMO RECOVERY ARCHITECTURE
Recovery begins:
Immediately after cannulation
Not
After decannulation
Recovery Pillars
Myocardial Recovery
Pulmonary Recovery
Neurologic Recovery
Endothelial Recovery
Functional Recovery
Developmental Recovery
SECTION 11
RHENOVA ECMO INNOVATIONS
Innovation 1
Neuroadaptive ECMO Surveillance
Continuous:
- NIRS
- EEG
- CAI
Integrated into ECMO decisions.
Innovation 2
Endothelial Preservation Platform
Continuous:
- EII
- Microvascular assessment
- Glycocalyx protection protocols
Innovation 3
ECMO Recovery Intelligence Engine
Predicts:
- Recovery probability
- Decannulation readiness
- Rehabilitation trajectory
Innovation 4
Pediatric Developmental Preservation Program
Tracks:
- Brain development
- Cognitive preservation
- Long-term educational outcomes
Innovation 5
Regenerative ECMO Interface
Supports future:
- Stem-cell therapies
- Exosome therapies
- Tissue regeneration programs
SECTION 12
ECMO CENTER PERFORMANCE METRICS
Clinical Metrics
Survival to decannulation
Survival to discharge
Neurologic preservation
Organ preservation
Recovery Metrics
CRIS
CRRI
Developmental outcomes
Rehabilitation participation
Biological Intelligence Metrics
ANMS
NCRS
STRI
EII
CAI
SECTION 13
ECMO CENTER OF EXCELLENCE CRITERIA
Bronze
Basic ECMO Program
Silver
Advanced ECMO Program
Gold
SCF-DBI ECMO Program
Platinum
RHENOVA Pediatric ECMO Center of Excellence
Requirements:
- Predictive surveillance
- Recovery intelligence
- Neurodevelopmental registry
- Regenerative integration
- Longitudinal outcome monitoring
SECTION 14
ECMO CENTER RESEARCH DIVISION
Research Areas
ECMO Neuroprotection
Endothelial Preservation
Immune Tolerance
Developmental Recovery
Regenerative Medicine
AI/CDSS ECMO Systems
Digital Twin Modeling
Recovery Intelligence Algorithms
SECTION 15
PROGRAM SUCCESS DEFINITION
The SCF-DBI Pediatric ECMO Center succeeds when it consistently:
Preserves life
Preserves brain function
Preserves endothelial integrity
Preserves immune competence
Preserves developmental potential
Restores functional independence
Restores family resilience
Optimizes long-term pediatric outcomes
Maximizes biologic intelligence preservation
Next Section Available:
Pediatric ECMO Center Operations Manual — Page 2
ECMO Candidate Identification, Activation Workflow, ECPR Activation System, Cannulation Operations, and First 24-Hour Stabilization Protocol.