Foundations of ECMO and ECMO Management Flashcards
7 cards from real ECMO practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Foundations of ECMO and ECMO Management flashcards as text
A centrifugal pump used in modern ECMO circuits generates flow primarily through:
Answer: Impeller or cone rotation creating centrifugal force
Centrifugal ECMO pumps use a rapidly spinning impeller or cone that imparts kinetic energy to blood through centrifugal force, generating flow.
When ECMO pump RPM is increased but flow does not increase proportionally, the most likely cause is:
Answer: Pump head thrombosis or increased circuit resistance
Increased RPM without proportional flow increase suggests elevated circuit resistance, often from clot formation in the pump head or oxygenator.
In neonatal ECMO for meconium aspiration syndrome, which mode is typically preferred as first-line?
Answer: VA-ECMO via carotid artery and jugular vein
Neonatal VA-ECMO via the right common carotid artery and right internal jugular vein is the standard approach because neonatal vessels are too small for suitable VV-ECMO cannulas.
The primary purpose of a 'lung rest' strategy during VV-ECMO for severe ARDS is to:
Answer: Apply ultra-protective ventilation settings to minimize ventilator-induced lung injury
Lung rest on VV-ECMO allows extreme reduction in mechanical ventilation parameters (low tidal volumes, low pressures, low rates) to minimize ongoing ventilator-induced lung injury.
Left ventricular distension (LV dilation) during VA-ECMO is most commonly managed by:
Answer: LV venting via an Impella device or atrial septostomy
LV venting with an Impella or atrial septostomy decompresses the distended LV, reduces wall stress, and may improve myocardial recovery.
Which circuit component is responsible for actively controlling temperature of blood returned to the patient?
Answer: Heat exchanger integrated into the oxygenator
The heat exchanger, typically incorporated within the ECMO oxygenator, uses water from a heater-cooler unit to regulate the temperature of blood passing through the circuit.
During an ECMO circuit emergency requiring hand cranking the pump, the clinician must ensure:
Answer: Adequate RPM is maintained to prevent retrograde blood flow
During manual hand cranking, sufficient rotational speed must be maintained because centrifugal pumps are non-occlusive and can allow retrograde flow if inadequate forward pressure is generated.