ECMO Complications & Management Flashcards
6 cards from real CES practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 ECMO Complications & Management flashcards as text
Recirculation in a VV ECMO circuit results in:
Answer: Decreased effective oxygen delivery despite high circuit flow because oxygenated blood is re-drained before reaching the patient
Recirculation occurs when oxygenated blood from the return cannula is immediately re-drained, reducing the fraction of oxygenated blood actually delivered to the patient.
What is the most effective way to reduce recirculation in a bicaval dual-lumen VV ECMO cannula?
Answer: Repositioning the cannula so the return port faces the tricuspid valve
Correct positioning of the dual-lumen cannula with the return port (Avalon/ProtekDuo) directed toward the tricuspid valve minimizes recirculation.
Hypertension (systemic) is a common complication in neonatal ECMO and is best managed by:
Answer: Antihypertensive therapy to prevent intracranial hemorrhage
Systemic hypertension in neonates on ECMO significantly increases the risk of intracranial hemorrhage and must be treated with antihypertensive agents.
A sudden drop in ECMO flow with high circuit pressures and visible dark, sluggish blood most likely indicates:
Answer: Massive circuit thrombosis
Dark sluggish blood with rising pressures and dropping flow indicates widespread circuit thrombosis, requiring emergency circuit change-out.
Thrombocytopenia on ECMO is caused by all of the following EXCEPT:
Answer: Increased thrombopoietin production causing sequestration
Thrombocytopenia on ECMO is caused by consumption, HIT, and hemodilution — thrombopoietin actually promotes platelet production rather than causing sequestration.
Which clinical sign most specifically indicates a cannula-related complication during ECMO?
Answer: Sudden unexplained desaturation with loss of circuit flow
Sudden desaturation combined with loss of circuit flow suggests cannula dislodgment, kinking, or obstruction — a direct cannula-related emergency.