ECMO QUESTIONS WITH VERIFIED
SOLUTIONS
What are some signs of recirculation seen due to femoral drainage ? - Correct Answers
-low SPO2 and high SVO2
return and access are RED
Optimal distance between cannulas
Only with VV ECMO
Failing Oxygenator signs on ECMO are? - Correct Answers -post oxygenator PO2
<200mmHg
Increase in Delta P, CO2, Part
Clots present
Increase in plasma free Hgb
What are the 4 factors of recirculation with VV ECMO? pg 125 from manual - Correct
Answers -1 pump flow
2 cannula position
3 cardiac output
4 intravascular volume (right atrial size)
How do you care for a patient on ECMO during cardiac arrest? - Correct Answers -
establish adequate flow???
CPR
When weaning off ECMO, what are the 3 variables that can be adjusted on the ECMO
system ? - Correct Answers -1 pump flow
2 FIO2
3 sweep rate
What happens when the cardio help is on LPM mode and you clamp the arterial line? -
Correct Answers -
VA ECMO indicated for lung failure only? t/f - Correct Answers -False
, VA ECMO is advantageous in patients with heart and lung problems. t/f - Correct
Answers -true
Central ECMO means patient cannulated where? - Correct Answers -Chest
Main difference between VV and VA ECMO is that VV provides no direct cardiac
support. t/f - Correct Answers -true
When assessing patient oxygenation status on VA ECMO, which is the best indicator of
adequacy of oxygenation? - Correct Answers -pre membrane oxygen sats
There are no absolute contraindications to ECLS? t/f - Correct Answers -false
Increasing ECMO blood flow in response to a low patient arterial sats in VV ECMO may
cause a decrease in oxygen delivery. t/f - Correct Answers -true
When using the cardio help the flow/bubble detector goes on what limb? - Correct
Answers -arterial
Avalon cannula is commonly used for VA ECMO. t/f - Correct Answers -false
Oxygen exchange in membrane lung effected by all EXCEPT the following: - Correct
Answers -blood path thickness
Centrifugal pumps exhibits the following characteristics: - Correct Answers -pre load
dependent and after load dependant
Centrifugal pump is set at 3600RPM and reading 4.3LPM. If the patient pressure
increases, what would you expect the LPM to do? - Correct Answers -decrease
The cardio help circuit has a bioline coating that contains what? - Correct Answers -
heparin and albumin
What is the gold standard anticoagulant used with ECMO? - Correct Answers -heparin
Which drug rapidly neutralizes heparin? - Correct Answers -protamine
What test measures the effect of heparin ? - Correct Answers -ACT
Why would we choose to use argatroban over heparin? - Correct Answers -Heparin
induced thrombocytopenia
What is the lowest recommended flow when weaning. from VA ECMO? - Correct
Answers -1LPM
SOLUTIONS
What are some signs of recirculation seen due to femoral drainage ? - Correct Answers
-low SPO2 and high SVO2
return and access are RED
Optimal distance between cannulas
Only with VV ECMO
Failing Oxygenator signs on ECMO are? - Correct Answers -post oxygenator PO2
<200mmHg
Increase in Delta P, CO2, Part
Clots present
Increase in plasma free Hgb
What are the 4 factors of recirculation with VV ECMO? pg 125 from manual - Correct
Answers -1 pump flow
2 cannula position
3 cardiac output
4 intravascular volume (right atrial size)
How do you care for a patient on ECMO during cardiac arrest? - Correct Answers -
establish adequate flow???
CPR
When weaning off ECMO, what are the 3 variables that can be adjusted on the ECMO
system ? - Correct Answers -1 pump flow
2 FIO2
3 sweep rate
What happens when the cardio help is on LPM mode and you clamp the arterial line? -
Correct Answers -
VA ECMO indicated for lung failure only? t/f - Correct Answers -False
, VA ECMO is advantageous in patients with heart and lung problems. t/f - Correct
Answers -true
Central ECMO means patient cannulated where? - Correct Answers -Chest
Main difference between VV and VA ECMO is that VV provides no direct cardiac
support. t/f - Correct Answers -true
When assessing patient oxygenation status on VA ECMO, which is the best indicator of
adequacy of oxygenation? - Correct Answers -pre membrane oxygen sats
There are no absolute contraindications to ECLS? t/f - Correct Answers -false
Increasing ECMO blood flow in response to a low patient arterial sats in VV ECMO may
cause a decrease in oxygen delivery. t/f - Correct Answers -true
When using the cardio help the flow/bubble detector goes on what limb? - Correct
Answers -arterial
Avalon cannula is commonly used for VA ECMO. t/f - Correct Answers -false
Oxygen exchange in membrane lung effected by all EXCEPT the following: - Correct
Answers -blood path thickness
Centrifugal pumps exhibits the following characteristics: - Correct Answers -pre load
dependent and after load dependant
Centrifugal pump is set at 3600RPM and reading 4.3LPM. If the patient pressure
increases, what would you expect the LPM to do? - Correct Answers -decrease
The cardio help circuit has a bioline coating that contains what? - Correct Answers -
heparin and albumin
What is the gold standard anticoagulant used with ECMO? - Correct Answers -heparin
Which drug rapidly neutralizes heparin? - Correct Answers -protamine
What test measures the effect of heparin ? - Correct Answers -ACT
Why would we choose to use argatroban over heparin? - Correct Answers -Heparin
induced thrombocytopenia
What is the lowest recommended flow when weaning. from VA ECMO? - Correct
Answers -1LPM
