ECMO Nutrition and Metabolic Management in ECMO 2

Question 1

Which electrolyte disturbance is particularly problematic when using continuous renal replacement therapy (CRRT) concurrently with ECMO?

Accepted Answer

Hypomagnesemia and hypophosphatemia

Answer

CRRT removes magnesium and phosphate from the blood continuously; without supplementation, patients on combined ECMO-CRRT are at high risk for hypomagnesemia and hypophosphatemia.

Question 2

What is the primary concern with administering lipid emulsions (as part of parenteral nutrition) to ECMO patients?

Accepted Answer

Lipid particles can coat and degrade the oxygenator membrane, reducing gas transfer efficiency

Answer

Fat emulsion particles can deposit on the oxygenator membrane and circuit components, degrading gas transfer performance and potentially clogging the circuit.

Question 3

Refeeding syndrome in ECMO patients is characterized by a critical drop in which electrolyte after nutrition initiation?

Accepted Answer

Phosphate

Answer

Refeeding syndrome is primarily characterized by hypophosphatemia due to rapid intracellular phosphate uptake when anabolic metabolism resumes after a period of starvation or catabolic stress.

Question 4

Which condition most commonly leads to enteral feeding intolerance in ECMO patients receiving VA ECMO?

Accepted Answer

Hypoxic gut ischemia due to retrograde aortic flow and reduced splanchnic perfusion

Answer

In VA ECMO, retrograde aortic flow can reduce antegrade pulsatile flow to mesenteric vessels, leading to gut hypoperfusion and feeding intolerance.

Question 5

What blood glucose target range is currently recommended for ECMO patients to balance glycemic control with hypoglycemia risk?

Accepted Answer

140–180 mg/dL

Answer

Current critical care guidelines, applicable to ECMO patients, recommend a blood glucose target of 140–180 mg/dL to reduce hypoglycemia risk while avoiding severe hyperglycemia.

ECMO - Extracorporeal Membrane Oxygenation Practice Test

ECMO - Extracorporeal Membrane Oxygenation Practice Test

ECMO Nutrition and Metabolic Management in ECMO 2