ECMO in Neonatal and Pediatric Populations Flashcards

Why is the right common carotid artery preferred over femoral access for arterial cannulation in neonatal VA-ECMO?

Answer: It provides direct retrograde perfusion to the aortic arch without lower limb ischemia risk

Carotid cannulation provides central oxygenated blood delivery to the aorta and coronaries without risking lower extremity ischemia from femoral cannulas.

Which complication is most feared in premature neonates on ECMO and contributes to its status as a relative contraindication in this population?

Answer: Intracranial hemorrhage (ICH)

The immature germinal matrix in premature neonates is highly susceptible to hemorrhage during ECMO anticoagulation, often resulting in fatal or severely disabling ICH.

The ELSO (Extracorporeal Life Support Organization) registry reports the highest survival rates among which ECMO patient group?

Answer: Neonatal respiratory ECMO

Neonatal respiratory ECMO has the best outcomes, with survival to discharge approximately 73% according to ELSO registry data.

What platelet count is typically targeted in pediatric ECMO patients to reduce bleeding risk without compromising circuit function?

Answer: >100,000/μL

Most pediatric ECMO centers target platelet counts >100,000/μL because thrombocytopenia is common due to platelet consumption by the circuit.

In pediatric ECMO for cardiac support, the most common underlying diagnosis requiring support is:

Answer: Post-cardiac surgery congenital heart disease

Post-operative low cardiac output syndrome following congenital heart disease repair is the leading indication for pediatric cardiac ECMO.

Which scoring tool based on ELSO registry data is used to estimate survival probability in neonates on ECMO?

Answer: Neonatal ECMO Predicted Survival Score

Survival prediction models derived from ELSO registry data stratify neonatal ECMO outcomes by diagnosis, helping guide counseling and resource allocation.