ECMO Foundations of ECMO and ECMO Management 2

Question 1

Which parameter best reflects the adequacy of oxygen delivery during VV-ECMO?

Accepted Answer

Mixed venous oxygen saturation (SvO2)

Answer

SvO2 reflects the balance between oxygen delivery and consumption, making it the best indicator of systemic oxygen adequacy in VV-ECMO.

Question 2

Recirculation during VV-ECMO is best defined as:

Accepted Answer

Oxygenated blood from the return cannula re-entering the drainage cannula

Answer

Recirculation occurs when oxygenated blood exiting the return cannula is immediately aspirated back into the drainage cannula before reaching the systemic circulation.

Question 3

The primary determinant of CO2 removal in the ECMO circuit is:

Accepted Answer

Sweep gas flow rate

Answer

Sweep gas flow (measured in L/min) is the primary control for CO2 removal; increasing sweep gas flow directly increases CO2 elimination.

Question 4

In VA-ECMO, retrograde aortic flow from a femoral arterial return cannula most significantly affects:

Accepted Answer

Left ventricular afterload

Answer

Retrograde femoral arterial return increases left ventricular afterload (increased impedance to ejection), which can worsen LV distension in a failing heart.

Question 5

Which cannula configuration is used in veno-arterial-venous (VAV) ECMO?

Accepted Answer

One venous drainage, one arterial return, and one additional venous return cannula

Answer

VAV-ECMO uses one venous drainage cannula with both an arterial and a venous return cannula, providing both cardiac and respiratory support while improving upper body oxygenation.

ECMO - Extracorporeal Membrane Oxygenation Practice Test

ECMO - Extracorporeal Membrane Oxygenation Practice Test

ECMO Foundations of ECMO and ECMO Management 2