CES ECMO Weaning & Decannulation

Question 1

Which parameter is most important to assess before attempting VV ECMO weaning?

Accepted Answer

Improvement in native lung compliance and gas exchange on reduced ECMO support

Answer

Normalization of serum lactate

Answer

Absence of fever for 24 hours

Answer

Resolution of chest X-ray infiltrates

Question 2

During a VV ECMO weaning trial, sweep gas flow is typically reduced to assess:

Accepted Answer

Native lung's ability to maintain gas exchange independently

Answer

Circuit blood flow tolerance

Answer

Hemodynamic stability off ECMO

Answer

Oxygenator membrane integrity

Question 3

For VA ECMO weaning, which hemodynamic parameter most reliably indicates cardiac recovery?

Accepted Answer

Pulse pressure > 10 mmHg on arterial waveform

Answer

Mean arterial pressure > 65 mmHg on vasopressors

Answer

Central venous pressure < 10 mmHg

Answer

Urine output > 0.5 mL/kg/hr

Question 4

Which echocardiographic finding supports readiness for VA ECMO weaning?

Accepted Answer

LVEF ≥ 20–25% with VTI > 10 cm

Answer

LVEF ≥ 50% with no regional wall motion abnormalities

Answer

Normal diastolic function only

Answer

Absence of pericardial effusion

Question 5

A VA ECMO weaning trial is typically performed by:

Accepted Answer

Gradually reducing ECMO flow while monitoring hemodynamics

Answer

Clamping the circuit and observing for 30 minutes

Answer

Increasing sweep gas to reduce circuit oxygen delivery

Answer

Removing the oxygenator from the circuit

Question 6

What is the minimum recommended ACT range during a weaning trial to reduce thrombosis risk without excessive bleeding?

Accepted Answer

160–180 seconds

Answer

120–140 seconds

Answer

200–220 seconds

Answer

240–260 seconds