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

Enteral nutrition is preferred in stable ECMO patients because it preserves gut integrity, reduces infection risk, and is associated with better outcomes compared to parenteral routes.

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

ECMO patients are in a hypercatabolic state, and current guidelines recommend 1.5–2.0 g/kg/day of protein to support nitrogen balance and minimize muscle wasting.

Question 3

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

Accepted Answer

Hyperglycemia

Answer

The systemic inflammatory response triggered by contact activation during ECMO promotes insulin resistance and stress hyperglycemia, making it the most common metabolic disturbance.

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

Early enteral nutrition within 24–48 hours of ECMO initiation is recommended in hemodynamically stable patients to reduce gut ischemia and support immunity.

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

Permissive underfeeding targeting 70–80% of energy expenditure during the acute phase avoids overfeeding complications such as hyperglycemia and lipogenesis while still providing metabolic support.

ECMO - Extracorporeal Membrane Oxygenation Practice Test

ECMO - Extracorporeal Membrane Oxygenation Practice Test

ECMO Nutrition and Metabolic Management in ECMO