CES ECMO Complications & Management 3

Question 1

Recirculation in a VV ECMO circuit results in:

Accepted Answer

Decreased effective oxygen delivery despite high circuit flow because oxygenated blood is re-drained before reaching the patient

Answer

Increased patient SaO2 with reduced ECMO flow

Answer

Improved CO2 removal efficiency

Answer

Circuit thrombosis risk reduction

Question 2

What is the most effective way to reduce recirculation in a bicaval dual-lumen VV ECMO cannula?

Accepted Answer

Repositioning the cannula so the return port faces the tricuspid valve

Answer

Increasing sweep gas flow

Answer

Reducing patient blood flow through the circuit

Answer

Adding a second venous drainage cannula

Question 3

Hypertension (systemic) is a common complication in neonatal ECMO and is best managed by:

Accepted Answer

Antihypertensive therapy to prevent intracranial hemorrhage

Answer

Increasing ECMO flow to reduce cardiac work

Answer

Sedation alone

Answer

Decreasing circuit temperature

Question 4

A sudden drop in ECMO flow with high circuit pressures and visible dark, sluggish blood most likely indicates:

Accepted Answer

Massive circuit thrombosis

Answer

Patient hypovolemia

Answer

Cannula kinking

Answer

Pump failure

Question 5

Thrombocytopenia on ECMO is caused by all of the following EXCEPT:

Accepted Answer

Increased thrombopoietin production causing sequestration

Answer

Platelet consumption by circuit surfaces

Answer

Heparin-induced thrombocytopenia

Answer

Hemodilution from circuit priming

Question 6

Which clinical sign most specifically indicates a cannula-related complication during ECMO?

Accepted Answer

Sudden unexplained desaturation with loss of circuit flow

Answer

Fever of 38.5°C

Answer

Rising creatinine over 48 hours

Answer

New onset atrial fibrillation