CCP Mechanical Circulatory Support & ECMO Management

Question 1

What is the primary indication for veno-arterial (VA) ECMO in the cardiac surgical setting?

Accepted Answer

Cardiogenic shock with refractory hemodynamic instability

Answer

VA-ECMO provides both cardiac output support and gas exchange, making it the appropriate intervention for cardiogenic shock when conventional therapies fail.

Question 2

In peripheral VA-ECMO, oxygenated blood is returned to which vessel?

Accepted Answer

Femoral artery

Answer

In peripheral VA-ECMO, the oxygenated blood is returned via the femoral artery so it enters the systemic arterial circulation to perfuse the body.

Question 3

What is the typical activated clotting time (ACT) target range maintained during ECMO support?

Accepted Answer

160–200 seconds

Answer

During ECMO, the ACT is typically maintained at 160–200 seconds, which provides adequate anticoagulation to prevent circuit thrombosis while minimizing bleeding risk.

Question 4

Which complication arises specifically from the retrograde aortic flow generated by femoral VA-ECMO?

Accepted Answer

Left ventricular distension

Answer

Retrograde femoral arterial return increases left ventricular afterload; if the native heart cannot eject effectively, the LV becomes distended, raising wall stress and myocardial oxygen demand.

Question 5

In the context of mechanical circulatory support, what does a 'bridge to transplant' (BTT) strategy mean?

Accepted Answer

Temporary support to stabilize a patient until a donor organ becomes available

Answer

BTT refers to using temporary mechanical support (such as ECMO or an LVAD) to keep a patient hemodynamically stable until a suitable cardiac donor organ is available.

(CCP) Certified Clinical Perfusionist Practice Test

(CCP) Certified Clinical Perfusionist Practice Test

CCP Mechanical Circulatory Support & ECMO Management