ECMO ECPR and Special Populations 3

Question 1

What term describes ECMO support initiated specifically to support a patient through a reversible cause of cardiac arrest when conventional CPR has failed?

Accepted Answer

ECPR (Extracorporeal CPR)

Answer

ECPR is the specific term for VA-ECMO deployed as an adjunct to conventional CPR for refractory cardiac arrest.

Question 2

In pregnant patients requiring ECMO, which hemodynamic position is recommended to optimize venous return?

Accepted Answer

Left lateral tilt of 15–30 degrees

Answer

Left lateral tilt relieves aortocaval compression by the gravid uterus, improving venous return to the ECMO circuit.

Question 3

Which lab finding most strongly suggests successful ECPR resuscitation and adequate end-organ perfusion?

Accepted Answer

Falling serum lactate over 4–6 hours

Answer

A downward trend in serum lactate is the most reliable indicator of restored oxygen delivery and end-organ recovery after ECPR.

Question 4

A patient with morbid obesity (BMI 55) requires ECPR. What circuit modification is most commonly necessary?

Accepted Answer

Larger cannula sizes with higher flow-rated tubing

Answer

Morbidly obese patients require larger cannulas and higher flow-rated tubing to achieve adequate perfusion for their increased body mass.

Question 5

Which ethical principle is MOST relevant when deciding NOT to initiate ECPR after 60 minutes of conventional CPR without ROSC?

Accepted Answer

Non-maleficence

Answer

Non-maleficence (do no harm) guides the decision to withhold futile ECPR when prolonged CPR indicates irreversible injury.

ECMO - Extracorporeal Membrane Oxygenation Practice Test

ECMO - Extracorporeal Membrane Oxygenation Practice Test

ECMO ECPR and Special Populations 3