ECMO ECMO in Neonatal and Pediatric Populations 3

Question 1

Which blood gas parameter is primarily controlled by adjusting the sweep gas flow rate in pediatric VV-ECMO?

Accepted Answer

PaCO2

Answer

PaO2

Answer

pH directly

Answer

Bicarbonate (HCO3)

Question 2

In VA-ECMO, 'differential hypoxia' (also called North-South syndrome) refers to:

Accepted Answer

Upper body hypoxia from native cardiac output while lower body receives oxygenated ECMO return

Answer

Higher SpO2 in the right hand compared to the left

Answer

Unequal oxygen saturation at pre- and post-membrane sites

Answer

Hypoxia in watershed zones of the brain

Question 3

The primary goal of ECMO support in pediatric myocarditis is:

Accepted Answer

Bridging to myocardial recovery or cardiac transplantation

Answer

Providing permanent cardiac replacement

Answer

Eliminating the need for inotropic medications

Answer

Treating the viral cause directly

Question 4

The typical ECMO blood flow rate target in neonates to achieve adequate oxygen delivery is approximately:

Accepted Answer

100–150 mL/kg/min

Answer

50–75 mL/kg/min

Answer

150–200 mL/kg/min

Answer

200–250 mL/kg/min

Question 5

To reduce intracranial pressure risk in neonates on ECMO, the recommended head and body positioning is:

Accepted Answer

Head of bed elevated 30° with head in midline position

Answer

Flat supine with neck in neutral alignment

Answer

Trendelenburg (head-down) position

Answer

Right lateral decubitus to protect the carotid cannula site

Question 6

A neonate on femoral VA-ECMO develops progressive ipsilateral lower extremity ischemia. The most appropriate intervention is:

Accepted Answer

Insert a distal perfusion catheter into the superficial femoral artery

Answer

Increase ECMO flow rate to improve peripheral perfusion

Answer

Immediately decannulate and transition to VV-ECMO

Answer

Administer systemic vasodilators to improve limb perfusion