A Homemade Low-Cost Agar-Agar Extracorporeal Membrane Oxygenation Cannulation Model for Extracorporeal Resuscitation Simulation

Extracorporeal cardiopulmonary resuscitation (ECPR) using venoarterial extracorporeal membrane oxygenation (VA ECMO) is a life-saving intervention for selected patients in refractory cardiac arrest. Given the procedure's technical complexity and time-critical nature, simulation-based training has become essential to ensure both technical proficiency and effective team coordination. However, current commercial simulators are often prohibitively expensive and lack the capacity to integrate ECMO cannulation into standard advanced life support (ALS) scenarios, limiting their real-world applicability and dissemination. To address this gap, we developed a low-cost, customizable phantom using agar-agar, basic household materials, and repurposed medical components. Our model enables ultrasound-guided vascular access, cannula insertion, and initiation of extracorporeal blood flow. It can be easily embedded within ALS mannequins, allowing seamless integration into high-fidelity ECPR simulations. The phantom realistically reproduces key procedural steps and supports training under the high-stress, time-sensitive conditions typical of ECPR. Its adaptability allows use in both technical workshops and in situ simulations involving multidisciplinary teams. This accessible, eco-friendly solution provides a practical alternative to commercial models, promoting broader implementation of ECPR training programs. It represents a step forward in bridging the gap between theoretical knowledge and hands-on practice in critical care education.