ECMO Nutrition and Metabolic Management in ECMO

Question 1

What is the preferred route of nutritional support for hemodynamically stable ECMO patients?

Accepted Answer

Enteral nutrition via nasogastric or nasoenteric tube

Answer

Total parenteral nutrition via central line

Answer

Peripheral parenteral nutrition

Answer

Oral feeding once sedation is reduced

Question 2

What is the recommended protein target for ECMO patients to support recovery and minimize muscle catabolism?

Accepted Answer

1.5–2.0 g/kg/day

Answer

0.5–0.8 g/kg/day

Answer

1.0–1.2 g/kg/day

Answer

2.5–3.0 g/kg/day

Question 3

Which metabolic disturbance is most commonly associated with ECMO-induced systemic inflammatory response?

Accepted Answer

Hyperglycemia

Answer

Hypoglycemia

Answer

Hyponatremia

Answer

Hypercalcemia

Question 4

When initiating enteral nutrition in an ECMO patient, what is the recommended timing after circuit initiation in a hemodynamically stable patient?

Accepted Answer

Within 24–48 hours

Answer

Immediately within 1 hour

Answer

After 72 hours once vasopressors are weaned

Answer

Only after ECMO flows are reduced below 3 L/min

Question 5

Which caloric target is most appropriate for an ECMO patient using a permissive underfeeding strategy in the acute phase?

Accepted Answer

70–80% of estimated energy expenditure

Answer

100–120% of estimated energy expenditure

Answer

50–60% of estimated energy expenditure

Answer

150% of estimated energy expenditure

Question 6

How does the ECMO circuit most directly impact drug and nutrient pharmacokinetics?

Accepted Answer

It sequesters lipophilic drugs and nutrients within the circuit tubing and oxygenator

Answer

It increases renal clearance of lipid-soluble compounds

Answer

It accelerates hepatic metabolism of protein-bound compounds

Answer

It reduces the volume of distribution for hydrophilic medications

Question 7

Which monitoring parameter is most useful for assessing adequacy of nutrition support and metabolic response in ECMO patients?

Accepted Answer

Indirect calorimetry measurement

Answer

Serum albumin levels weekly

Answer

Daily urine urea nitrogen excretion only

Answer

Body weight measured every 48 hours