ECMO Veno-Arterial (VA) ECMO Management 4

Question 1

What is the most common cannulation site for peripheral VA ECMO in adults?

Accepted Answer

Femoral vein and femoral artery

Answer

Femoral vein to femoral artery cannulation is the most common approach for peripheral VA ECMO due to accessibility and speed of insertion.

Question 2

Which patient population may benefit most from axillary artery VA ECMO cannulation over femoral arterial cannulation?

Accepted Answer

Patients with severe peripheral vascular disease or aortic insufficiency

Answer

Axillary artery cannulation is preferred in patients with severe femoral/iliac vascular disease or significant aortic insufficiency, and it also provides antegrade upper body perfusion.

Question 3

What does a sudden drop in the ECMO sweep gas FiO2 setting achieve during management?

Accepted Answer

Reduces oxygenation to test native lung function

Answer

Reducing sweep gas FiO2 (a 'sweep trial') tests the native lung's ability to oxygenate blood, used during VV ECMO weaning assessments.

Question 4

In VA ECMO, the drainage cannula is typically positioned in which location?

Accepted Answer

Right atrium via femoral vein

Answer

The venous drainage cannula tip is ideally positioned at the right atrial/IVC junction via femoral vein to maximize venous return.

Question 5

Which cardiac rhythm is most concerning when attempting to wean a patient from VA ECMO support?

Accepted Answer

Ventricular fibrillation

Answer

Ventricular fibrillation indicates no effective native cardiac output, making weaning impossible and requiring immediate defibrillation or continuation of full ECMO support.

ECMO - Extracorporeal Membrane Oxygenation Practice Test

ECMO - Extracorporeal Membrane Oxygenation Practice Test

ECMO Veno-Arterial (VA) ECMO Management 4