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
What is the most appropriate strategy for managing hyperglycemia in an ECMO patient receiving continuous enteral nutrition?
Answer: Use a continuous insulin infusion titrated per a validated insulin protocol
Continuous insulin infusion with a validated ICU insulin protocol provides the most consistent glycemic control in ECMO patients receiving continuous nutrition.
In a VV ECMO patient with acute respiratory distress syndrome (ARDS), what respiratory quotient (RQ) target from indirect calorimetry suggests optimal substrate utilization?
Answer: RQ 0.85–1.0
An RQ of 0.85–1.0 indicates balanced substrate oxidation of carbohydrates and fats, while RQ > 1.0 suggests overfeeding and net lipogenesis, increasing CO2 production.
Which vitamin deficiency is most clinically significant and requires routine supplementation in ECMO patients due to its role in oxidative stress management?
Answer: Vitamin C (ascorbic acid)
Vitamin C is a critical antioxidant consumed rapidly during the oxidative stress of ECMO-mediated inflammation, and supplementation has been investigated to attenuate organ dysfunction.
How should nutritional support be adjusted when an ECMO patient is transitioned from the acute inflammatory phase to the recovery phase?
Answer: Advance to full caloric targets and maintain high protein to support anabolism and rehabilitation
During the recovery phase, patients shift from catabolism to anabolism, and advancing to full caloric and protein targets supports muscle repair, weaning, and functional recovery.
Which feeding approach is recommended for ECMO patients who are prone positional or have impaired gastric emptying?
Answer: Post-pyloric (small bowel) enteral feeding
Post-pyloric feeding bypasses the stomach and is preferred when gastric emptying is impaired or prone positioning makes aspiration risk prohibitive.
What effect does therapeutic hypothermia (if used during ECMO) have on nutritional management?
Answer: It decreases metabolic rate, reducing caloric requirements and slowing GI motility
Therapeutic hypothermia reduces metabolic rate by approximately 7% per degree Celsius drop in core temperature and impairs GI motility, necessitating reduced caloric delivery and monitoring for feeding intolerance.
What is the most important nutritional consideration when weaning an ECMO patient toward extubation and oral intake?
Answer: Transitioning gradually from enteral to oral feeding while monitoring swallowing safety
Gradual transition with dysphagia screening and swallowing assessment ensures nutritional continuity while minimizing aspiration risk as enteral support is weaned and oral intake resumes.