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Veno-Venous (VV) 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-Venous (VV) ECMO Management flashcards as text

  1. Which factor most reliably predicts the ability to successfully wean a patient from VV ECMO?

    Answer: Maintenance of adequate SpO2 during a spontaneous breathing trial with sweep gas off

    A weaning trial with sweep gas reduced or off tests the native lung's ability to maintain gas exchange independently, which is the best predictor of successful decannulation.

  2. What ventilator strategy is recommended for native lung protection during VV ECMO support?

    Answer: Ultra-protective ventilation: low Vt (2–4 mL/kg), low rate, permissive hypercapnia

    ECMO allows ultra-protective ventilation with very low tidal volumes and rates, minimizing ventilator-induced lung injury while the circuit maintains gas exchange.

  3. During VV ECMO, a patient develops severe hypokalemia (K+ 2.8 mEq/L). Which factor unique to ECMO contributes to electrolyte depletion?

    Answer: Continuous renal replacement therapy often co-administered

    Many ECMO patients receive concurrent CRRT, which significantly increases electrolyte clearance and requires aggressive electrolyte replacement.

  4. A VV ECMO patient has a post-membrane pO2 of 500 mmHg but SvO2 measured from the drainage cannula is only 55%. What does this indicate?

    Answer: High oxygen consumption relative to delivery

    Low drainage cannula SvO2 (which approximates true mixed venous oxygen saturation) indicates high oxygen extraction due to elevated consumption or insufficient delivery.

  5. Which intervention is indicated when a VV ECMO patient develops massive intracranial hemorrhage?

    Answer: Discontinue anticoagulation and consider urgent decannulation

    Massive ICH on ECMO requires stopping anticoagulation immediately, and if the hemorrhage is life-threatening, urgent decannulation should be considered despite ECMO dependence.

  6. What is the primary purpose of the 'blender' on the sweep gas inlet of a VV ECMO oxygenator?

    Answer: To control the FiO2 of sweep gas for oxygenation regulation

    The sweep gas blender adjusts oxygen concentration (FiO2) to regulate the amount of oxygen transferred across the membrane to the blood.

  7. A patient has been on VV ECMO for 14 days. Platelet count drops from 120,000 to 48,000 over 5 days despite no obvious bleeding. What is the most likely cause?

    Answer: Consumptive thrombocytopenia from circuit contact activation

    Chronic contact of blood with artificial circuit surfaces activates platelets and causes ongoing consumption, making thrombocytopenia a common feature of prolonged ECMO.