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Veno-Arterial (VA) 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 Veno-Arterial (VA) ECMO Management flashcards as text

  1. Which hemodynamic finding is most consistent with the 'North-South syndrome' (Harlequin syndrome) in peripheral VA ECMO?

    Answer: Hypoxic upper body with well-oxygenated lower body

    In Harlequin syndrome, retrograde ECMO flow oxygenates the lower body while the patient's own failing heart delivers desaturated blood to the upper body and coronary arteries.

  2. A patient on peripheral VA ECMO develops limb ischemia in the cannulated leg. What is the primary intervention?

    Answer: Place a distal perfusion cannula in the superficial femoral artery

    A distal perfusion cannula (DPC) inserted antegrade into the superficial femoral artery restores distal limb perfusion while maintaining ECMO support.

  3. What does a persistently elevated pulmonary artery pressure on VA ECMO most likely indicate?

    Answer: LV distension due to insufficient venting

    Elevated PA pressures on VA ECMO suggest the left ventricle is distending because it cannot eject against the increased afterload imposed by the circuit.

  4. Which parameter best reflects native cardiac recovery during VA ECMO weaning trials?

    Answer: Pulse pressure amplitude on arterial waveform

    Increasing pulse pressure amplitude on the arterial waveform indicates the native heart is generating stroke volume, a key sign of myocardial recovery.

  5. In VA ECMO, the 'mixing cloud' refers to:

    Answer: The zone in the aorta where ECMO and native cardiac output blood mix

    The mixing cloud is the aortic zone where retrograde oxygenated ECMO blood meets antegrade native cardiac output; its position determines differential oxygenation.

  6. A VA ECMO patient's ACT target is typically maintained between:

    Answer: 160–200 seconds

    ACT is generally maintained at 160–200 seconds on VA ECMO to balance thrombosis prevention against bleeding risk.

  7. Which echocardiographic finding would prompt emergent LV venting in a VA ECMO patient?

    Answer: Severely dilated, non-contracting LV with mitral regurgitation

    A severely dilated, non-contracting LV with MR indicates LV distension that can cause pulmonary edema and myocardial injury, requiring urgent venting.