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 preferred route of nutritional support for hemodynamically stable ECMO patients?
Answer: Enteral nutrition via nasogastric or nasoenteric tube
Enteral nutrition is preferred in stable ECMO patients because it preserves gut integrity, reduces infection risk, and is associated with better outcomes compared to parenteral routes.
What is the recommended protein target for ECMO patients to support recovery and minimize muscle catabolism?
Answer: 1.5–2.0 g/kg/day
ECMO patients are in a hypercatabolic state, and current guidelines recommend 1.5–2.0 g/kg/day of protein to support nitrogen balance and minimize muscle wasting.
Which metabolic disturbance is most commonly associated with ECMO-induced systemic inflammatory response?
Answer: Hyperglycemia
The systemic inflammatory response triggered by contact activation during ECMO promotes insulin resistance and stress hyperglycemia, making it the most common metabolic disturbance.
When initiating enteral nutrition in an ECMO patient, what is the recommended timing after circuit initiation in a hemodynamically stable patient?
Answer: Within 24–48 hours
Early enteral nutrition within 24–48 hours of ECMO initiation is recommended in hemodynamically stable patients to reduce gut ischemia and support immunity.
Which caloric target is most appropriate for an ECMO patient using a permissive underfeeding strategy in the acute phase?
Answer: 70–80% of estimated energy expenditure
Permissive underfeeding targeting 70–80% of energy expenditure during the acute phase avoids overfeeding complications such as hyperglycemia and lipogenesis while still providing metabolic support.
How does the ECMO circuit most directly impact drug and nutrient pharmacokinetics?
Answer: It sequesters lipophilic drugs and nutrients within the circuit tubing and oxygenator
Lipophilic drugs and nutrients bind to the polyvinyl chloride tubing, silicone membranes, and oxygenator of the ECMO circuit, reducing effective plasma concentrations.
Which monitoring parameter is most useful for assessing adequacy of nutrition support and metabolic response in ECMO patients?
Answer: Indirect calorimetry measurement
Indirect calorimetry provides the most accurate measure of resting energy expenditure in ECMO patients, guiding precise caloric prescription and avoiding over- or underfeeding.