Mechanical Circulatory Support & ECMO Management Flashcards
7 cards from real CCP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Mechanical Circulatory Support & ECMO Management flashcards as text
The intraaortic balloon pump (IABP) improves coronary artery perfusion through which mechanism?
Answer: Inflating during diastole to increase diastolic aortic pressure
The IABP inflates at the onset of diastole, raising diastolic aortic pressure and thereby increasing coronary perfusion pressure, since coronary filling primarily occurs during diastole.
What is the standard first-line anticoagulant used during ECMO support?
Answer: Unfractionated heparin
Unfractionated heparin is the preferred anticoagulant for ECMO because it can be rapidly titrated, monitored with ACT or aPTT, and reversed with protamine if needed.
A patient on peripheral VA-ECMO develops 'Harlequin syndrome.' What pathophysiology does this describe?
Answer: Upper body hypoxia when poorly oxygenated native cardiac output mixes with ECMO-oxygenated return before reaching the cerebral circulation
Harlequin (north-south) syndrome occurs when a recovering native heart ejects deoxygenated blood that perfuses the upper body before retrograde femoral ECMO-oxygenated blood can reach it, causing upper body hypoxia.
Which parameter best reflects the adequacy of systemic oxygen delivery during ECMO support?
Answer: Mixed venous oxygen saturation (SvO2)
Mixed venous oxygen saturation reflects the balance between oxygen delivery and tissue consumption; a declining SvO2 indicates that tissues are extracting more oxygen because delivery is insufficient.
What is the typical ECMO circuit flow rate range required to provide adequate cardiac output support in an adult on VA-ECMO?
Answer: 2.5–4.5 L/min
Adult VA-ECMO typically targets flows of 2.5–4.5 L/min to approximate normal resting cardiac output and maintain adequate systemic perfusion.
Which condition is a contraindication to intraaortic balloon pump (IABP) insertion?
Answer: Moderate aortic regurgitation
Aortic regurgitation is a contraindication because IABP inflation during diastole raises aortic root pressure, worsening regurgitant volume back into the already failing left ventricle.
In ECMO circuit management, what is the primary function of the sweep gas flowing through the oxygenator?
Answer: To remove carbon dioxide from the blood
Sweep gas (typically oxygen or an oxygen/air blend) flows countercurrent across the oxygenator membrane to remove carbon dioxide; increasing sweep flow lowers PaCO2.