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ECMO Specialist Exam Questions and Answers
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How to recognize cardiogenic shock? (acronym) Ans: CS-MODE
Cardiac Rhythm
SBP <90
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Markers- cardiac
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Output- oliguria
Drips - Inotropes/ pressers
Exam - cool, clammy, resp distress
How to diagnose shock ( acronym) Ans: (ECLS )
ECG
Consult- surgeon
Labs- lactates, abgs etc.
Swan catheter
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what is PAPI score? Formula and normal value Ans: differentiates
between the LV/RV disfunction, if low = RV dysfunction
PAPi= (sPAP-dPAP)/RA
it is the pa sys - the pa dyastolic / right atrial pressure- can get these
numbers from swan
normal is >1.0
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Formula for cardiac power output (CPO) and normal value Ans: CPO=
MAP x CO/451
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normal = 0.7 to 1 W
what are the three key measurements for cardiogenic shock? Ans: PAPI
CPO
Lactate
what is cardiac power output? Ans: amount of energy available to
maintain the perfusion of the vital organs in shock
what does lactate in the blood mean and normal value? Ans: anerobic
metabolism is occurring
normal is 0.9 to 1.7
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what are the two goals of mechanical circulatory support? Ans: restore
adequate end organ perfusion
ventricular unloading
how does the impella CP work as an LV vent? Ans: drains at LV and
returns at the aortic arch
provides 3-3.5 LPM of flow
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what are the 5 factors affecting pharmacokinetics with critical illness?
Ans: 1. augmented cardiac output
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2. leaky capillaries
3. volume resusitation
4. end-organ perfusion
5. altered protein binding
what is pharmacodynamics? Ans: the bodys biological response to the
drug
what are the factors 5 affecting pharmacokinetics with ECMO? Ans: 1.
augmented cardiac output
2. leaky capillaries
3. end-organ perfusion