CES ECMO Weaning & Decannulation 2

Question 1

After successful decannulation of a femoral arterial VA ECMO cannula, the preferred method of hemostasis is:

Accepted Answer

Figure-of-eight suture with surgical cut-down or purse-string closure

Answer

Femoral arterial decannulation typically requires surgical closure (figure-of-eight or purse-string suture) due to the large-bore cannula size.

Question 2

Limb ischemia distal to a femoral arterial ECMO cannula is best managed by:

Accepted Answer

Insertion of a distal perfusion cannula (DPC) in the superficial femoral artery

Answer

A distal perfusion cannula inserted into the superficial femoral artery restores antegrade flow to the ischemic limb during ongoing ECMO support.

Question 3

Which sign during VV ECMO decannulation indicates a potentially dangerous air embolism risk?

Accepted Answer

Patient coughing or taking deep breath during cannula removal

Answer

Inspiration during venous decannulation creates negative intrathoracic pressure that can entrain air through the open cannulation site into the venous system.

Question 4

What Trendelenburg positioning maneuver during venous decannulation helps prevent air embolism?

Accepted Answer

15–30° Trendelenburg (head down)

Answer

Trendelenburg (head-down) positioning raises venous pressure at the cannulation site, reducing the risk of air entrainment during decannulation.

Question 5

Following decannulation, how long is bed rest typically recommended after femoral venous ECMO cannula removal?

Accepted Answer

4–6 hours

Answer

Approximately 4–6 hours of bed rest after femoral venous decannulation is standard practice to ensure hemostasis and prevent hematoma formation.

CES - Certified ECMO Specialist Practice Test

CES - Certified ECMO Specialist Practice Test

CES ECMO Weaning & Decannulation 2