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
The pre-pump (inlet) pressure on an ECMO circuit is characteristically:
Answer: Negative, reflecting the suction generated by the drainage cannula
The inlet (drainage) limb operates at subatmospheric (negative) pressure as the pump generates suction to pull blood from the venous circulation.
An ECMO patient develops sudden circuit thrombosis with loss of flow. The immediate priority is:
Answer: Clamp cannulas, initiate CPR if indicated, and prepare for emergency circuit change
Cannula clamping prevents air or emboli from entering the patient, CPR maintains perfusion if needed, and a circuit change is performed urgently to restore ECMO support.
When weaning VV-ECMO, the clinician assesses readiness by:
Answer: Reducing sweep gas flow to zero and observing native gas exchange on the ventilator
A VV-ECMO weaning trial involves turning sweep gas to zero so the oxygenator is bypassed functionally, allowing assessment of whether the native lungs can sustain adequate gas exchange.
A patient on VA-ECMO for cardiogenic shock shows improving echo function. The correct weaning strategy involves:
Answer: Gradually reducing ECMO flow while monitoring hemodynamic parameters and echo
VA-ECMO is weaned by stepwise flow reductions with concurrent hemodynamic and echocardiographic monitoring to confirm the heart can sustain adequate output.
Which laboratory finding during ECMO warrants the most urgent evaluation for heparin-induced thrombocytopenia (HIT)?
Answer: Platelet count drop of greater than 50% on days 5–10 despite no circuit changes
A >50% platelet count drop on days 5–10 of heparin exposure is the classic temporal pattern raising strong suspicion for HIT, warranting a 4T score assessment and HIT antibody testing.
The term 'ECMO-CPR' (ECPR) refers to:
Answer: Initiating VA-ECMO during active cardiac arrest to restore perfusion
ECPR is the deployment of VA-ECMO during refractory cardiac arrest to restore systemic perfusion and allow time for resuscitation, intervention, or recovery.
Which statement about the ECMO oxygenator membrane is correct?
Answer: Modern hollow-fiber membranes use microporous or diffusion-based fibers to transfer gases without plasma leak
Contemporary hollow-fiber oxygenators use polymethylpentene (PMP) or similar fibers that permit gas diffusion while preventing plasma from leaking into the gas phase.