FREE ECMO Physiology and Pathophysiology Questions and Answers
What is the primary mechanism of gas exchange in veno-venous ECMO?
Explanation:
In veno-venous ECMO, gas exchange primarily occurs through diffusion across the membrane of the oxygenator, allowing oxygen to move into the blood and carbon dioxide to move out.
In ECMO, what does the oxygenator do?
Explanation:
The oxygenator in ECMO is responsible for oxygenating the blood and removing carbon dioxide, mimicking the function of the lungs.
What is the main cause of oxygenator failure in ECMO?
Explanation:
Thrombus formation within the oxygenator is a common cause of oxygenator failure in ECMO, leading to decreased gas exchange efficiency.
What is the primary function of ECMO in respiratory failure?
Explanation:
The primary function of ECMO in respiratory failure is to act as an artificial lung, providing oxygen to the blood and removing carbon dioxide.
What is the primary concern regarding bleeding in patients on ECMO?
Explanation:
The primary concern regarding bleeding in ECMO patients is the risk of blood clot formation due to the contact of blood with the artificial surfaces of the ECMO circuit.
Why are the first 16 minutes of a cardiac arrest so important?
Explanation:
The first 16 minutes of a cardiac arrest is very important. Research shows that the majority of patients with good neurologic outcomes after a cardiac arrest obtain ROSC within 16 minutes. ECMO and ECPR (refractory arrest, “ECMO Alert”) are for those who don’t obtain ROSC in the first 16 minutes. This is why the goal is to keep scene time less than 18 minutes. Therefore, if no ROSC after 2 shocks, transport immediately.
Which condition is ECMO primarily used for in respiratory failure?
Explanation:
ECMO is commonly used in cases of ARDS where conventional mechanical ventilation is inadequate to oxygenate the blood.
How does ECMO impact cardiac output?
Explanation:
ECMO can decrease cardiac output as the pump may provide some of the blood flow that would normally be generated by the heart.
We can potentially use ECPR (refractory arrest) for cardiac arrests in V-fib and V-tach, why can’t we use it for asystole?
Explanation:
Generally, we think of V-fib and V-tach as potential cardiac causes of cardiac arrest. For ECPR (refractory arrest, “ECMO Alert”) to be effective, there needs to be something to fix in the cath lab such as a blocked coronary artery. Asystole, along with other causes of arrest, are less likely to be cardiogenic. Other types of arrests that are excluded are traumatic arrests and police arrests.
What is ECMO?
Explanation:
ECMO is an acronym that stands for Extracorporeal Membrane Oxygenation. It is a pump that circulates blood through an artificial lung to provide oxygenation. This can support the lungs or the lungs and heart. This technique started in the 1950s to bypass damaged and diseased lungs in infants.
What are the indications for use of ECMO?
Explanation:
There are many uses of ECMO, and trials are ongoing as we discover more ways to use ECMO. Here are some of the known uses:
Refractory Ventricular Fibrillation cardiac arrest (VFIB arrest)
Pulmonary embolism with shock
Massive overdose
Amniotic fluid embolism following pregnancy
Hypothermia and Hypothermic cardiac arrest
Drowning
ARDS