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Nutrition and Metabolic Management in ECMO 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 Nutrition and Metabolic Management in ECMO flashcards as text

  1. Which electrolyte disturbance is particularly problematic when using continuous renal replacement therapy (CRRT) concurrently with ECMO?

    Answer: Hypomagnesemia and hypophosphatemia

    CRRT removes magnesium and phosphate from the blood continuously; without supplementation, patients on combined ECMO-CRRT are at high risk for hypomagnesemia and hypophosphatemia.

  2. What is the primary concern with administering lipid emulsions (as part of parenteral nutrition) to ECMO patients?

    Answer: Lipid particles can coat and degrade the oxygenator membrane, reducing gas transfer efficiency

    Fat emulsion particles can deposit on the oxygenator membrane and circuit components, degrading gas transfer performance and potentially clogging the circuit.

  3. Refeeding syndrome in ECMO patients is characterized by a critical drop in which electrolyte after nutrition initiation?

    Answer: Phosphate

    Refeeding syndrome is primarily characterized by hypophosphatemia due to rapid intracellular phosphate uptake when anabolic metabolism resumes after a period of starvation or catabolic stress.

  4. Which condition most commonly leads to enteral feeding intolerance in ECMO patients receiving VA ECMO?

    Answer: Hypoxic gut ischemia due to retrograde aortic flow and reduced splanchnic perfusion

    In VA ECMO, retrograde aortic flow can reduce antegrade pulsatile flow to mesenteric vessels, leading to gut hypoperfusion and feeding intolerance.

  5. What blood glucose target range is currently recommended for ECMO patients to balance glycemic control with hypoglycemia risk?

    Answer: 140–180 mg/dL

    Current critical care guidelines, applicable to ECMO patients, recommend a blood glucose target of 140–180 mg/dL to reduce hypoglycemia risk while avoiding severe hyperglycemia.

  6. How does ECMO most significantly alter zinc and selenium homeostasis?

    Answer: Adsorption of trace elements onto the circuit and oxygenator leads to reduced plasma levels

    Selenium and zinc are adsorbed onto circuit components and consumed by the inflammatory response during ECMO, leading to clinically significant depletion requiring supplementation.

  7. What nutritional intervention has been shown to be harmful and is NOT recommended in critically ill ECMO patients?

    Answer: Enteral glutamine supplementation at high doses in multi-organ failure

    High-dose enteral glutamine supplementation was associated with increased mortality in critically ill patients with multi-organ failure in the REDOXS trial and is not recommended.