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

Improved native lung gas exchange and compliance on progressively reduced sweep gas and/or flow indicates readiness for VV ECMO weaning.

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

Reducing sweep gas (CO2 removal drive) while monitoring SpO2 and PaCO2 tests whether the native lungs can sustain adequate gas exchange.

Question 3

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

Accepted Answer

Pulse pressure > 10 mmHg on arterial waveform

Answer

Return of pulsatility (pulse pressure >10 mmHg) on the arterial waveform indicates improved native cardiac output during VA ECMO.

Question 4

Which echocardiographic finding supports readiness for VA ECMO weaning?

Accepted Answer

LVEF ≥ 20–25% with VTI > 10 cm

Answer

An LVEF ≥ 20–25% with LVOT VTI > 10 cm suggests sufficient cardiac recovery to tolerate a weaning trial.

Question 5

A VA ECMO weaning trial is typically performed by:

Accepted Answer

Gradually reducing ECMO flow while monitoring hemodynamics

Answer

Stepwise reduction of VA ECMO flow while monitoring hemodynamics and end-organ perfusion is the standard weaning trial approach.

CES - Certified ECMO Specialist Practice Test