CVP CVP ECMO and Mechanical Circulatory Support 1 — Questions and Answers
Question 1: What does the abbreviation ECMO stand for?
- External Cardiac Monitoring Output
- Extracorporeal Membrane Oxygenation (Correct answer)
- Enhanced Cardiopulmonary Machine Operation
- Extravascular Circulatory Membrane Oxygenator
Correct answer: Extracorporeal Membrane Oxygenation
ECMO stands for Extracorporeal Membrane Oxygenation, a life-support technique that oxygenates and removes CO2 from blood outside the body.
Question 2: Which ECMO configuration provides both cardiac and respiratory support simultaneously?
- Veno-venous (VV) ECMO
- Veno-arterial (VA) ECMO (Correct answer)
- Arterio-venous (AV) ECMO
- Veno-portal ECMO
Correct answer: Veno-arterial (VA) ECMO
VA-ECMO returns oxygenated blood to the arterial circulation, bypassing both the heart and lungs to provide combined cardiopulmonary support.
Question 3: Veno-venous ECMO is primarily indicated for which clinical condition?
- Cardiogenic shock
- Severe isolated respiratory failure (Correct answer)
- Cardiac arrest without respiratory failure
- Aortic dissection
Correct answer: Severe isolated respiratory failure
VV-ECMO provides respiratory support only, returning oxygenated blood to the venous system for the patient's own heart to pump, making it suitable for respiratory failure with preserved cardiac function.
Question 4: Which type of pump is most commonly used in modern ECMO circuits?
- Roller pump
- Pulsatile diaphragm pump
- Centrifugal pump (Correct answer)
- Axial flow pump
Correct answer: Centrifugal pump
Centrifugal pumps are preferred in ECMO because they are less traumatic to blood cells, have no tubing wear, and are safer if flow is occluded.
Question 5: What is the typical ACT target range for anticoagulation during ECMO support?
- 100–150 seconds
- 180–220 seconds (Correct answer)
- 300–400 seconds
- 450–600 seconds
Correct answer: 180–220 seconds
An ACT of 180–220 seconds (or anti-Xa guided heparin with aPTT 60–80 seconds) balances circuit thrombosis risk against bleeding complications during ECMO.
Question 6: In peripheral femoral VA-ECMO, venous drainage is typically obtained from which vessel?
- Femoral artery
- Subclavian vein
- Femoral vein or internal jugular vein (Correct answer)
- Superior vena cava only
Correct answer: Femoral vein or internal jugular vein
The venous drainage cannula is placed in the femoral vein (or internal jugular vein), advanced to the right atrium to drain deoxygenated blood to the ECMO circuit.
CVP CVP ECMO and Mechanical Circulatory Support 1
What does the abbreviation ECMO stand for?