ECMO ECPR and Special Populations 2

Question 1

What is the maximum recommended 'no-flow' time before ECPR initiation to expect meaningful neurological recovery?

Accepted Answer

5 minutes

Answer

Witnessed cardiac arrest with no-flow time under 5 minutes is associated with better neurological outcomes after ECPR.

Question 2

In pediatric ECPR, which circuit component is most commonly downsized compared to adult configurations?

Accepted Answer

The oxygenator membrane surface area

Answer

Pediatric ECPR uses smaller oxygenator membrane surface areas to match the lower blood flow requirements and reduce prime volume.

Question 3

During ECPR for in-hospital cardiac arrest, chest compressions should be continued until ECMO flow reaches which threshold?

Accepted Answer

Full target flow

Answer

CPR should continue until ECMO reaches full target flow to ensure uninterrupted perfusion during cannulation and ramp-up.

Question 4

Which underlying rhythm is associated with the BEST outcomes in ECPR?

Accepted Answer

Ventricular fibrillation

Answer

Ventricular fibrillation as the initial arrest rhythm is associated with the best ECPR survival because myocardial viability is often preserved.

Question 5

A neonate on ECPR has an arterial PaO2 of 400 mmHg. What is the most appropriate adjustment?

Accepted Answer

Reduce FiO2 in the sweep gas blender

Answer

Hyperoxia in neonates is harmful; reducing sweep gas FiO2 via the blender lowers delivered oxygen concentration to the circuit.

ECMO - Extracorporeal Membrane Oxygenation Practice Test