ECMO Practice Test

ECMO Exam at a Glance

What changed for ECMO in 2026

• Oct 29, 2026: Delivery (AmSECT CES-A / CES-P) changed to Online (EasyLMS) with an approved neutral proctor present (previously Online (EasyLMS) with a neutral in-person proctor).^[1]
• Oct 29, 2026: Delivery (ELSO E-AEC / E-NPEC) changed to Virtual proctored exam (Meazure Learning) (previously Virtual proctored exam).^[3]
• Oct 29, 2026: Eligibility (AmSECT CES-A / CES-P) changed to Employed in an ECMO Specialist role; 2 years' experience recommended (previously Employed in ECMO Specialist role; 2 years' experience recommended).^[1]
• Oct 29, 2026: Exam fee (AmSECT CES-A / CES-P) changed to $150 non-refundable exam fee (previously $150 exam fee (non-refundable)).^[1]
• Oct 29, 2026: Exam fee (ELSO E-AEC / E-NPEC) changed to $300 non-refundable exam fee (no application fee) (previously $300 per exam (non-refundable)).^[2]
• Oct 29, 2026: Late registration deadline (AmSECT CES-A / CES-P) changed to Late recertification: +$50 within 3 months, then +$100 (previously Recert late fee $50, rising to $100).^[1]
• Oct 29, 2026: Registration deadline (AmSECT CES-A / CES-P) changed to Fall 2026 application period: Sept 21–Oct 23, 2026 (previously Fall 2026 applications: Sep 21–Oct 23, 2026 (closed)).
• Oct 29, 2026: Registration opens (AmSECT CES-A / CES-P) changed to Offered 3x/year (May, Aug, Nov); applications open ~2 months before (previously Offered 3x/year (May, Aug, Nov); applications open ~2 months prior).^[1]
• Oct 29, 2026: Registration opens (ELSO E-AEC / E-NPEC) changed to Rolling: apply any time once criteria are met (previously Rolling — apply any time once criteria are met).^[3]
• Oct 29, 2026: Renewal (ELSO E-AEC / E-NPEC) changed to Every 3 years: 30 CE hours + average 56 ECMO care hours per year (previously 30 CE hours + avg 56 ECMO care hours/year, every 3 years).^[4]
• Oct 29, 2026: Retake fee (AmSECT CES-A / CES-P) changed to $100 if retaken within 9 months (previously $100 retake fee within 9 months).^[1]
• Oct 29, 2026: Retake policy (AmSECT CES-A / CES-P) changed to Pay retake fee, submit updated proctor form, notify IBBM (previously Pay retake fee, submit updated proctor form, and notify IBBM).^[1]

Many hospitals will sponsor your ECMO certification costs and pay for training courses as part of their investment in the cardiac support team.

According to American Society of ExtraCorporeal Technology (AmSECT) with the International Board of Blood Management (IBBM), which ru, “The exam consists of 100 questions, and examinees have three (3) hours to complete it.”^[1]

ECMO content outline and where to practise each area

The content areas below are copied from the official ECMO content outline published by American Society of ExtraCorporeal Technology (AmSECT) with the International Board of Blood Management (IBBM), which ru. The right-hand column shows which of our practice sets covers it.

Worked examples: how to reason through ECMO questions

These are practice questions written for this site, not questions from the real exam. Each explanation shows why the right answer is right and why the others are wrong.

Example 1

Question: A routine blood gas analysis from the ECMO circuit shows a pre-oxygenator PaO2 of 40 mmHg and a post-oxygenator PaO2 of 150 mmHg. The sweep gas blender is set to 100% FiO2. What is the most likely interpretation of these findings?

1. The patient's native lung function has significantly improved.
2. The oxygenator is failing and requires imminent change-out.
3. There is significant recirculation of oxygenated blood.
4. The blood pump is malfunctioning, causing inadequate flow.

Answer: B. The oxygenator is failing and requires imminent change-out.

Explanation:

B is correct. With the sweep blender at 100% FiO2, a healthy membrane should lift blood oxygen far above the 150 mmHg measured after the oxygenator. The pre-oxygenator PaO2 of 40 mmHg shows normal venous blood arriving, so the problem is gas transfer across the membrane. The usual cause is fibrin or clot on the fibres.

• A is wrong because native lung recovery does not change how much oxygen the membrane adds between the pre and post samples.
• C is wrong because recirculation raises the pre-oxygenator value. It does not lower the post-oxygenator PaO2.
• D is wrong because pump flow changes how much blood gets oxygenated, not the oxygen tension of blood leaving the membrane.

Rule: judge the oxygenator by comparing pre- and post-membrane gases at full sweep FiO2. A low post-membrane PaO2 points to the membrane itself.

Example 2

Question: The ELSO (Extracorporeal Life Support Organization) registry reports the highest survival rates among which ECMO patient group?

1. Neonatal cardiac ECMO
2. Pediatric cardiac ECMO
3. Neonatal respiratory ECMO
4. Adult respiratory ECMO

Answer: C. Neonatal respiratory ECMO

Explanation:

C is correct. In ELSO registry reports, neonatal respiratory ECMO has the best survival of the main patient groups. These infants usually have reversible conditions, such as meconium aspiration or persistent pulmonary hypertension of the newborn, and their hearts are often otherwise healthy.

• A is wrong because neonatal cardiac patients often have complex congenital heart disease or low output after surgery, and both lower survival.
• B is wrong for similar reasons, since pediatric cardiac runs often follow surgery, myocarditis or cardiomyopathy.
• D is wrong because adult respiratory patients tend to have more comorbidities and longer runs.

Rule: survival follows how reversible the underlying problem is. Newborn respiratory failure is the classic reversible indication, while cardiac support carries more risk.

Example 3

Question: Which blood gas parameter is MOST useful to assess oxygenator function independent of recirculation on VV ECMO?

1. Pre-membrane arterial blood gas
2. Post-membrane pO2
3. Mixed venous saturation from a Swan-Ganz catheter
4. Peripheral SpO2

Answer: B. Post-membrane pO2

Explanation:

B is correct. Post-membrane pO2 is measured on blood that has just left the oxygenator. It shows what the membrane is doing regardless of recirculation or native heart and lung function.

• A is wrong because on VV ECMO, pre-membrane blood is drainage blood that may already contain recirculated oxygenated return blood. It tells you about recirculation, not about the membrane.
• C is wrong because mixed venous saturation also depends on cardiac output, oxygen consumption and recirculation.
• D is wrong because peripheral SpO2 combines native lung function, circuit flow and native cardiac output into one reading.

Rule: to isolate the oxygenator, sample just after it and compare with the pre-membrane gas. To judge recirculation, look at pre-membrane saturation.

How to use these practice tests

Start with the official page for your exam, either AmSECT's CES-A or CES-P page or ELSO's E-AEC and E-NPEC pages. Note the eligibility rules and the content areas you see least at work. Then take the free ECMO practice test untimed to find your weak areas.

• Work through the topic sets in blueprint order: foundations and physiology, then cannulation and VV and VA management, then anticoagulation, pharmacology and monitoring.
• Read every explanation, including on questions you got right, and write the rule in your own words.
• Connect each topic to your unit's protocols for circuit checks, blood gas sampling and alarm response. Exam scenarios are easier when you can picture them at the bedside.
• Do at least one timed run. For AmSECT, practise pacing 100 questions in 3 hours. For ELSO, build stamina for 120 NBME-style questions.
• Before your window opens, redo only the questions you missed and review the complications and troubleshooting and weaning sets.
• Set up your proctor (AmSECT) or Meazure Learning booking (ELSO) early so logistics do not take time away from study.

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Ensure you log all your pump hours and continuing education credits. Lapsing requires retaking the full ECMO exam.

Official Resources

• Extracorporeal Life Support Organization (ELSO) is the international nonprofit that publishes the ECMO guidelines, registry data, and standards most hospital training programs are built on.
• ELSO ECMO Education lists the official courses, simulation training, and continuing-education options ELSO offers for bedside ECMO specialists.
• Society of Critical Care Medicine (SCCM) provides critical-care education and resources that complement ECMO preparation for ICU nurses, perfusionists, and physicians.

Sources & last verified

1. American Society of ExtraCorporeal Technology (AmSECT) with the International Board of Blood Management (IBBM), which ru — number of questions, time limit, exam fee, retake fee (official source). “The exam consists of 100 questions, and examinees have three (3) hours to complete it.” Verified Oct 29, 2026 · source checked Oct 28, 2026.
2. elso.org — number of questions, exam fee, validity (official source). “Both individual certification exams consist of 120 NBME-style questions designed to assess ECMO knowledge.” Verified Oct 29, 2026 · source checked Oct 18, 2026.
3. elso.org — retake policy, delivery, registration opens, testing window (official source). “Retesting may only occur after ELSO opens the next exam testing period following the close of the testing window in which the individual failed or…” Verified Oct 29, 2026 · source checked Oct 18, 2026.
4. elso.org — renewal (official source). “This includes completing 30 hours of Continuing Education (CEs) within the scope of the practitioner’s daily work related to ECMO, and providing a minimum average…” Verified Oct 29, 2026 · source checked Oct 18, 2026.
5. American Society of ExtraCorporeal Technology (AmSECT) with the International Board of Blood Management (IBBM), which ru — other (official source). “ecmo 1.1 terminology” Verified Oct 29, 2026.

How we verify: editorial & fact-checking policy. Report an error: contact us.