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Patient Monitoring and Assessment 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.

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  1. Which parameter most directly indicates adequate oxygen delivery during ECMO support?

    Answer: Mixed venous oxygen saturation (SvO2) 65-75%

    SvO2 of 65-75% reflects the balance between oxygen delivery and consumption, indicating adequate systemic perfusion during ECMO.

  2. During VV-ECMO, a patient's native SpO2 drops despite stable ECMO flow. What should the clinician assess first?

    Answer: Recirculation fraction

    Recirculation occurs when oxygenated blood is re-aspirated by the drainage cannula, reducing effective oxygen delivery and causing SpO2 to drop despite adequate flows.

  3. What is the significance of a widening arteriovenous CO2 difference (AVCO2 gap) in an ECMO patient?

    Answer: Inadequate tissue perfusion and anaerobic metabolism

    A widening AVCO2 gap (>6 mmHg) suggests poor cardiac output and tissue hypoperfusion with anaerobic CO2 production.

  4. In VA-ECMO, the 'north-south syndrome' or differential hypoxia is identified by comparing:

    Answer: Right radial and femoral arterial blood gas values

    Right radial (upper body, native heart output) vs. femoral (ECMO-oxygenated blood) ABG comparison identifies differential hypoxia when the failing heart ejects desaturated blood to the upper body.

  5. Which neurological monitoring tool is most commonly used at the bedside during neonatal ECMO?

    Answer: Near-infrared spectroscopy (NIRS)

    NIRS is widely used during neonatal ECMO to continuously monitor cerebral regional oxygen saturation (rSO2) and detect neurological compromise non-invasively.

  6. A sudden decrease in ECMO venous drainage pressure (more negative) with unchanged pump speed most likely indicates:

    Answer: Hypovolemia or cannula malposition

    Increasingly negative inlet pressures with unchanged RPM suggest inadequate venous return due to hypovolemia, tamponade, or cannula migration causing 'chatter.'

  7. Which laboratory value is most critical to monitor for detecting hemolysis during ECMO?

    Answer: Plasma-free hemoglobin

    Plasma-free hemoglobin rises when red blood cells are lysed by mechanical shear forces in the circuit, and levels >50 mg/dL indicate significant hemolysis.