ECMO WITH
ANSWERS 2025
1. Dr. John Gibbon - ANSWER:-Helped develop the first heart lung machine & had
the first successful open heart operation using the heart-lung machine in 1954.
2. Dr. Robert Bartlett - ANSWER:-The "father of ECMO" who pioneered ECMO
technology, usage & research. Surgeon who had the first neonatal ECMO
survivor in 1972.
3. Robert Hooke - ANSWER:-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*
4. Bubble Oxygenator - ANSWER:-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.
5. 1916 - ANSWER:-Year Heparin was discovered when Jay Maclean
demonstrates that a phosphatide extracted from canine heart muscle prevents
coagulation of the blood.
6. 1929 - ANSWER:-Year of whole-body extracorporeal perfusion of a dog
completed by the Russians Brukhonenko and Tchetchuline.
7. 1953 - ANSWER:-Year of first successful intracardiac repair using extracorporeal
oxygenation & John Gibbons heart-lung machine
,8. 10% - ANSWER:-By 1957, mortality from intracardiac surgery dropped from 50%
to
9. 1971 - ANSWER:-Year of first successful adult ECMO patient who suffered
polytrauma with aortic transection & ARDS
10. Esmeralda - ANSWER:-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%).
11. ELSO - ANSWER:-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
12. H1N1 - ANSWER:-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.
13. *CESAR* (Conventional ventilatory support vs extracorporeal membrane
oxygenation for severe adult respiratory failure) *Trail* - ANSWER:-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.
14. Centrifugal Pump - ANSWER:-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.
15. PolyMethylPentene (PMP) Oxygenators - ANSWER:-Emerging ECMO
technology which use true non-porous membrane technology which can last a
long period of time.
16. Biocompatible Cannulas & Circuits - ANSWER:-Emerging ECMO technology
which prevents clot formation & platelet activation in the cannulas & circuit
1. Centrifugal Pump
,2. PolyMethylPentene (PMP) Oxygenators
3. Biocompatible Cannulas & Circuits - ANSWER:-3 Emerging ECMO
Technologies
a. ANSWER:-
17. Diffusion - ANSWER:-The process that allows gas exchange between the alveoli
& pulmonary capillaries. It allows O2 & CO2 move from areas of high
concentration to low concentration
18. pO2= 100
19. pCO2= 40 - ANSWER:-Partial Pressure of Oxygen (pO2) & Carbon Dioxide
(pCO2) in the alveoli
20. pO2=40
21. pCO2=45 - ANSWER:-Partial Pressure of Oxygen (pO2) & Carbon Dioxide
(pCO2) entering the alveolar capillaries from venous circulation (in pulmonary
artery)
1. Hemoglobin (98.5%)- oxyhemoglobin
2. Dissolved in Plasma (1.5%)- paO2 - ANSWER:-2 Ways Oxygen is Carried in
the Blood
22. 98.5% - ANSWER:-% of oxygen bound to hemoglobin
23. 1.5% - ANSWER:-% of oxygen dissolved in plasma
1. Bicarbonate- HCO3 (60%)
2. Carbanimohemoglobin (30%)
3. Dissolved in Plasma (10%) - ANSWER:-3 Ways Carbon Dioxide is Carried in
the blood
24. Bicarbonate (HCO3) - ANSWER:-Formed when CO2 (released by cells making
ATP) combines with H2O (due to the enzyme Carbonic anhydrase)
25. 60% - ANSWER:-% of carbon dioxide transported as *Bicarbonate*
26. Carbaminohemoglobin (HbCO2) - ANSWER:-Carbon dioxide bound to
hemoglobin- hemoglobin molecules loose their oxygen when they bind carbon
dioxide
, 27. 30% - ANSWER:-% of carbon dioxide transported as Carbaminohemoglobin
28. 10% - ANSWER:-% of carbon dioxide dissolved in plasma
29. Aerobic
30. Anaerobic - ANSWER:-2 Types of Cellular Metabolism
31. Aerobic - ANSWER:-Type of metabolism that creates energy with *oxygen*
32. Anaerobic - ANSWER:-Type of metabolism that creates energy without oxygen
and results in *lactic acid* production & eventual metabolic acidosis
33. Metabolic rate- example kidneys & heart have a high metabolic rate so have high
blood flow - ANSWER:-Most organ systems determine blood flow based on their
34. SHOCK - ANSWER:-Develops if cells do not get steady supply of oxygen to
meet their metabolic needs, they convert to *Anarobic* metabolism with lactic
acidosis
35. Oxygen Delivery (DO2) - ANSWER:-The amount of oxygen delivered to the
peripheral tissues each minute. It depends on Cardiac Output, Hemoglobin
Concentration, Hemoglobin Saturation (SpO2) and dissolved Oxygen (PaO2) in
plasma
36. Cardiac Output
37. Hemoglobin
38. Arterial Oxygenation (SaO2): bound to hemoglobin (SpO2) & dissolved in plasma
(pO2) - ANSWER:-3 Factors that Control Oxygen Delivery (DO2)
39. Oxygen Consumption (VO2) - ANSWER:-The amount of oxygen used by the
tissues each minute which is determined by organ specific cellular metabolism,
mass & activity, thyroid, hypothalamus & catecholamines.
40. Organ Specific Cellular Metabolism
41. Mass & Activity
42. Thyroid, Hypothalamus, Catecholamines - ANSWER:-3 Factors that determine
Oxygen Consumption
43. Inotropes
44. Trauma
ANSWERS 2025
1. Dr. John Gibbon - ANSWER:-Helped develop the first heart lung machine & had
the first successful open heart operation using the heart-lung machine in 1954.
2. Dr. Robert Bartlett - ANSWER:-The "father of ECMO" who pioneered ECMO
technology, usage & research. Surgeon who had the first neonatal ECMO
survivor in 1972.
3. Robert Hooke - ANSWER:-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*
4. Bubble Oxygenator - ANSWER:-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.
5. 1916 - ANSWER:-Year Heparin was discovered when Jay Maclean
demonstrates that a phosphatide extracted from canine heart muscle prevents
coagulation of the blood.
6. 1929 - ANSWER:-Year of whole-body extracorporeal perfusion of a dog
completed by the Russians Brukhonenko and Tchetchuline.
7. 1953 - ANSWER:-Year of first successful intracardiac repair using extracorporeal
oxygenation & John Gibbons heart-lung machine
,8. 10% - ANSWER:-By 1957, mortality from intracardiac surgery dropped from 50%
to
9. 1971 - ANSWER:-Year of first successful adult ECMO patient who suffered
polytrauma with aortic transection & ARDS
10. Esmeralda - ANSWER:-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%).
11. ELSO - ANSWER:-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
12. H1N1 - ANSWER:-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.
13. *CESAR* (Conventional ventilatory support vs extracorporeal membrane
oxygenation for severe adult respiratory failure) *Trail* - ANSWER:-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.
14. Centrifugal Pump - ANSWER:-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.
15. PolyMethylPentene (PMP) Oxygenators - ANSWER:-Emerging ECMO
technology which use true non-porous membrane technology which can last a
long period of time.
16. Biocompatible Cannulas & Circuits - ANSWER:-Emerging ECMO technology
which prevents clot formation & platelet activation in the cannulas & circuit
1. Centrifugal Pump
,2. PolyMethylPentene (PMP) Oxygenators
3. Biocompatible Cannulas & Circuits - ANSWER:-3 Emerging ECMO
Technologies
a. ANSWER:-
17. Diffusion - ANSWER:-The process that allows gas exchange between the alveoli
& pulmonary capillaries. It allows O2 & CO2 move from areas of high
concentration to low concentration
18. pO2= 100
19. pCO2= 40 - ANSWER:-Partial Pressure of Oxygen (pO2) & Carbon Dioxide
(pCO2) in the alveoli
20. pO2=40
21. pCO2=45 - ANSWER:-Partial Pressure of Oxygen (pO2) & Carbon Dioxide
(pCO2) entering the alveolar capillaries from venous circulation (in pulmonary
artery)
1. Hemoglobin (98.5%)- oxyhemoglobin
2. Dissolved in Plasma (1.5%)- paO2 - ANSWER:-2 Ways Oxygen is Carried in
the Blood
22. 98.5% - ANSWER:-% of oxygen bound to hemoglobin
23. 1.5% - ANSWER:-% of oxygen dissolved in plasma
1. Bicarbonate- HCO3 (60%)
2. Carbanimohemoglobin (30%)
3. Dissolved in Plasma (10%) - ANSWER:-3 Ways Carbon Dioxide is Carried in
the blood
24. Bicarbonate (HCO3) - ANSWER:-Formed when CO2 (released by cells making
ATP) combines with H2O (due to the enzyme Carbonic anhydrase)
25. 60% - ANSWER:-% of carbon dioxide transported as *Bicarbonate*
26. Carbaminohemoglobin (HbCO2) - ANSWER:-Carbon dioxide bound to
hemoglobin- hemoglobin molecules loose their oxygen when they bind carbon
dioxide
, 27. 30% - ANSWER:-% of carbon dioxide transported as Carbaminohemoglobin
28. 10% - ANSWER:-% of carbon dioxide dissolved in plasma
29. Aerobic
30. Anaerobic - ANSWER:-2 Types of Cellular Metabolism
31. Aerobic - ANSWER:-Type of metabolism that creates energy with *oxygen*
32. Anaerobic - ANSWER:-Type of metabolism that creates energy without oxygen
and results in *lactic acid* production & eventual metabolic acidosis
33. Metabolic rate- example kidneys & heart have a high metabolic rate so have high
blood flow - ANSWER:-Most organ systems determine blood flow based on their
34. SHOCK - ANSWER:-Develops if cells do not get steady supply of oxygen to
meet their metabolic needs, they convert to *Anarobic* metabolism with lactic
acidosis
35. Oxygen Delivery (DO2) - ANSWER:-The amount of oxygen delivered to the
peripheral tissues each minute. It depends on Cardiac Output, Hemoglobin
Concentration, Hemoglobin Saturation (SpO2) and dissolved Oxygen (PaO2) in
plasma
36. Cardiac Output
37. Hemoglobin
38. Arterial Oxygenation (SaO2): bound to hemoglobin (SpO2) & dissolved in plasma
(pO2) - ANSWER:-3 Factors that Control Oxygen Delivery (DO2)
39. Oxygen Consumption (VO2) - ANSWER:-The amount of oxygen used by the
tissues each minute which is determined by organ specific cellular metabolism,
mass & activity, thyroid, hypothalamus & catecholamines.
40. Organ Specific Cellular Metabolism
41. Mass & Activity
42. Thyroid, Hypothalamus, Catecholamines - ANSWER:-3 Factors that determine
Oxygen Consumption
43. Inotropes
44. Trauma
