ECMO EXAM 2025/2026 QUESTIONS AND
ANSWERS 100% PASS.
Dr. John Gibbon - ANS Helped develop the first heart lung machine & had the first successful
open heart operation using the heart-lung machine in 1954.
Dr. Robert Bartlett - ANS The "father of ECMO" who pioneered ECMO technology, usage &
research. Surgeon who had the first neonatal ECMO survivor in 1972.
Robert Hooke - ANS English physicist who discovered the law of elasticity , known as Hooke's
law , and constructed the Boylean air pump making him the first person to *conceptualize an
oxygenator*
Bubble Oxygenator - ANS An early implementation of the oxygenator which was first
developed in 1882 by von Schröder of Strasburg when he used it to oxygenate an isolated
kidney. It was later used for cardiopulmonary bypass in 1950 by Clark, Gollan, and Gupta. It
faced initial skepticism but in 1956 it was demonstrated to be relatively simple, inexpensive, &
easy to operate. The device faced competition from membrane oxygenators, which arrived
within the same decade & were found to provide better oxygenation for periods over eight
hours, and other advantages beyond six hours. However, most open-heart operations were
substantially shorter, and by 1976 it was predominant. In the 1980s, it was replaced by
microporous membrane oxygenators.
1916 - ANS Year Heparin was discovered when Jay Maclean demonstrates that a phosphatide
extracted from canine heart muscle prevents coagulation of the blood.
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,1929 - ANS Year of whole-body extracorporeal perfusion of a dog completed by the Russians
Brukhonenko and Tchetchuline.
1953 - ANS Year of first successful intracardiac repair using extracorporeal oxygenation &
John Gibbons heart-lung machine
10% - ANS By 1957, mortality from intracardiac surgery dropped from 50% to
1971 - ANS Year of first successful adult ECMO patient who suffered polytrauma with aortic
transection & ARDS
Esmeralda - ANS Abandoned neonate who was successfully placed on ECMO in 1975. She
suffered meconium aspiration & spent 72 hours on ECMO (Prior to ECMO, meconium aspiration
had a 90% mortality rate. Post ECMO, survival rate is 75%).
ELSO - ANS International organization created in *1989* which maintains a registry of both
facilities & specialists trained to provide ECMO services. It also maintains registry information
that is used to support clinical research, support regulatory agencies, & provides educational
programs for active centers as well as for facilities who may be involved in the transfer of
patients to higher levels of care
H1N1 - ANS First ever WHO "public health emergency of international concern" which CDC
estimated 284,000 deaths globally (mostly in Africa & Southwest Asia). In 2009, CESAR trail
increased ECMO use in adults & the development of national ECMO programs.
*CESAR* (Conventional ventilatory support vs extracorporeal membrane oxygenation for severe
adult respiratory failure) *Trail* - ANS Study during H1N1 flu epidemic that demonstrated
that patients with ARDS had better outcomes on ECMO then those with traditional ventilator
management. It helped increase ECMO use in adults & developed national ECMO programs. It
studied a total of 180 patients with primary endpoint measuring their survival without severe
disability at 6 months- 63% EMCO patients survived 6 months verses 47% without. Most
patients in the study developed severe ARDS with a P:F<75 & 30% of the control group did not
receive lung protective ventilation.
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,Centrifugal Pump - ANS Emerging ECMO technology that uses nonpostive displacement to
allow flow which is directly related to the patients condition. It is affected by both preload &
afterload.
PolyMethylPentene (PMP) Oxygenators - ANS Emerging ECMO technology which use true
non-porous membrane technology which can last a long period of time.
Biocompatible Cannulas & Circuits - ANS Emerging ECMO technology which prevents clot
formation & platelet activation in the cannulas & circuit
1. Centrifugal Pump
2. PolyMethylPentene (PMP) Oxygenators
3. Biocompatible Cannulas & Circuits - ANS 3 Emerging ECMO Technologies
- ANS
Diffusion - ANS The process that allows gas exchange between the alveoli & pulmonary
capillaries. It allows O2 & CO2 move from areas of high concentration to low concentration
pO2= 100
pCO2= 40 - ANS Partial Pressure of Oxygen (pO2) & Carbon Dioxide (pCO2) in the alveoli
pO2=40
pCO2=45 - ANS Partial Pressure of Oxygen (pO2) & Carbon Dioxide (pCO2) entering the
alveolar capillaries from venous circulation (in pulmonary artery)
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, 1. Hemoglobin (98.5%)- oxyhemoglobin
2. Dissolved in Plasma (1.5%)- paO2 - ANS 2 Ways Oxygen is Carried in the Blood
98.5% - ANS % of oxygen bound to hemoglobin
1.5% - ANS % of oxygen dissolved in plasma
1. Bicarbonate- HCO3 (60%)
2. Carbanimohemoglobin (30%)
3. Dissolved in Plasma (10%) - ANS 3 Ways Carbon Dioxide is Carried in the blood
Bicarbonate (HCO3) - ANS Formed when CO2 (released by cells making ATP) combines with
H2O (due to the enzyme Carbonic anhydrase)
60% - ANS % of carbon dioxide transported as *Bicarbonate*
Carbaminohemoglobin (HbCO2) - ANS Carbon dioxide bound to hemoglobin- hemoglobin
molecules loose their oxygen when they bind carbon dioxide
30% - ANS % of carbon dioxide transported as Carbaminohemoglobin
10% - ANS % of carbon dioxide dissolved in plasma
Aerobic
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
ANSWERS 100% PASS.
Dr. John Gibbon - ANS Helped develop the first heart lung machine & had the first successful
open heart operation using the heart-lung machine in 1954.
Dr. Robert Bartlett - ANS The "father of ECMO" who pioneered ECMO technology, usage &
research. Surgeon who had the first neonatal ECMO survivor in 1972.
Robert Hooke - ANS English physicist who discovered the law of elasticity , known as Hooke's
law , and constructed the Boylean air pump making him the first person to *conceptualize an
oxygenator*
Bubble Oxygenator - ANS An early implementation of the oxygenator which was first
developed in 1882 by von Schröder of Strasburg when he used it to oxygenate an isolated
kidney. It was later used for cardiopulmonary bypass in 1950 by Clark, Gollan, and Gupta. It
faced initial skepticism but in 1956 it was demonstrated to be relatively simple, inexpensive, &
easy to operate. The device faced competition from membrane oxygenators, which arrived
within the same decade & were found to provide better oxygenation for periods over eight
hours, and other advantages beyond six hours. However, most open-heart operations were
substantially shorter, and by 1976 it was predominant. In the 1980s, it was replaced by
microporous membrane oxygenators.
1916 - ANS Year Heparin was discovered when Jay Maclean demonstrates that a phosphatide
extracted from canine heart muscle prevents coagulation of the blood.
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,1929 - ANS Year of whole-body extracorporeal perfusion of a dog completed by the Russians
Brukhonenko and Tchetchuline.
1953 - ANS Year of first successful intracardiac repair using extracorporeal oxygenation &
John Gibbons heart-lung machine
10% - ANS By 1957, mortality from intracardiac surgery dropped from 50% to
1971 - ANS Year of first successful adult ECMO patient who suffered polytrauma with aortic
transection & ARDS
Esmeralda - ANS Abandoned neonate who was successfully placed on ECMO in 1975. She
suffered meconium aspiration & spent 72 hours on ECMO (Prior to ECMO, meconium aspiration
had a 90% mortality rate. Post ECMO, survival rate is 75%).
ELSO - ANS International organization created in *1989* which maintains a registry of both
facilities & specialists trained to provide ECMO services. It also maintains registry information
that is used to support clinical research, support regulatory agencies, & provides educational
programs for active centers as well as for facilities who may be involved in the transfer of
patients to higher levels of care
H1N1 - ANS First ever WHO "public health emergency of international concern" which CDC
estimated 284,000 deaths globally (mostly in Africa & Southwest Asia). In 2009, CESAR trail
increased ECMO use in adults & the development of national ECMO programs.
*CESAR* (Conventional ventilatory support vs extracorporeal membrane oxygenation for severe
adult respiratory failure) *Trail* - ANS Study during H1N1 flu epidemic that demonstrated
that patients with ARDS had better outcomes on ECMO then those with traditional ventilator
management. It helped increase ECMO use in adults & developed national ECMO programs. It
studied a total of 180 patients with primary endpoint measuring their survival without severe
disability at 6 months- 63% EMCO patients survived 6 months verses 47% without. Most
patients in the study developed severe ARDS with a P:F<75 & 30% of the control group did not
receive lung protective ventilation.
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,Centrifugal Pump - ANS Emerging ECMO technology that uses nonpostive displacement to
allow flow which is directly related to the patients condition. It is affected by both preload &
afterload.
PolyMethylPentene (PMP) Oxygenators - ANS Emerging ECMO technology which use true
non-porous membrane technology which can last a long period of time.
Biocompatible Cannulas & Circuits - ANS Emerging ECMO technology which prevents clot
formation & platelet activation in the cannulas & circuit
1. Centrifugal Pump
2. PolyMethylPentene (PMP) Oxygenators
3. Biocompatible Cannulas & Circuits - ANS 3 Emerging ECMO Technologies
- ANS
Diffusion - ANS The process that allows gas exchange between the alveoli & pulmonary
capillaries. It allows O2 & CO2 move from areas of high concentration to low concentration
pO2= 100
pCO2= 40 - ANS Partial Pressure of Oxygen (pO2) & Carbon Dioxide (pCO2) in the alveoli
pO2=40
pCO2=45 - ANS Partial Pressure of Oxygen (pO2) & Carbon Dioxide (pCO2) entering the
alveolar capillaries from venous circulation (in pulmonary artery)
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, 1. Hemoglobin (98.5%)- oxyhemoglobin
2. Dissolved in Plasma (1.5%)- paO2 - ANS 2 Ways Oxygen is Carried in the Blood
98.5% - ANS % of oxygen bound to hemoglobin
1.5% - ANS % of oxygen dissolved in plasma
1. Bicarbonate- HCO3 (60%)
2. Carbanimohemoglobin (30%)
3. Dissolved in Plasma (10%) - ANS 3 Ways Carbon Dioxide is Carried in the blood
Bicarbonate (HCO3) - ANS Formed when CO2 (released by cells making ATP) combines with
H2O (due to the enzyme Carbonic anhydrase)
60% - ANS % of carbon dioxide transported as *Bicarbonate*
Carbaminohemoglobin (HbCO2) - ANS Carbon dioxide bound to hemoglobin- hemoglobin
molecules loose their oxygen when they bind carbon dioxide
30% - ANS % of carbon dioxide transported as Carbaminohemoglobin
10% - ANS % of carbon dioxide dissolved in plasma
Aerobic
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
