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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. What is the most common cannulation site for peripheral VA ECMO in adults?

    Answer: Femoral vein and femoral artery

    Femoral vein to femoral artery cannulation is the most common approach for peripheral VA ECMO due to accessibility and speed of insertion.

  2. Which patient population may benefit most from axillary artery VA ECMO cannulation over femoral arterial cannulation?

    Answer: Patients with severe peripheral vascular disease or aortic insufficiency

    Axillary artery cannulation is preferred in patients with severe femoral/iliac vascular disease or significant aortic insufficiency, and it also provides antegrade upper body perfusion.

  3. What does a sudden drop in the ECMO sweep gas FiO2 setting achieve during management?

    Answer: Reduces oxygenation to test native lung function

    Reducing sweep gas FiO2 (a 'sweep trial') tests the native lung's ability to oxygenate blood, used during VV ECMO weaning assessments.

  4. In VA ECMO, the drainage cannula is typically positioned in which location?

    Answer: Right atrium via femoral vein

    The venous drainage cannula tip is ideally positioned at the right atrial/IVC junction via femoral vein to maximize venous return.

  5. Which cardiac rhythm is most concerning when attempting to wean a patient from VA ECMO support?

    Answer: Ventricular fibrillation

    Ventricular fibrillation indicates no effective native cardiac output, making weaning impossible and requiring immediate defibrillation or continuation of full ECMO support.

  6. A patient on VA ECMO develops sudden bright red blood in the ECMO circuit tubing after a position change. This most likely represents:

    Answer: Accidental connection of the drainage and return lines

    Bright red blood in the drainage line (which should be dark venous blood) suggests the drainage and return cannulas have been accidentally switched, a life-threatening error.

  7. What is the significance of a widening pulse pressure on the arterial line of a VA ECMO patient over 48 hours?

    Answer: Evidence of myocardial recovery with improving native cardiac output

    Widening pulse pressure indicates the native heart is generating increasing stroke volume, which is a positive sign of myocardial recovery during VA ECMO.