RT240 Module 4 Study Guide – Questions With
Fully Explained Solutions
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Terms in this set (60)
o to deliver adequate amounts of oxygen, and remove
carbon dioxide while the lungs and/or heart recover, or
Describe the primary goals
in some cases until the lungs or heart can be
of extracorporeal
transplanted
membrane oxygenation
o And in cases of VA ECMO, provide hemodynamic
support
o have a strong science background, a thorough
understanding of cardiopulmonary physiology, and the
ability to handle and manage highly technical
Describe the respiratory
equipment
therapist's role as an ECMO
o provide hour-to-hour management of the ECMO
specialist
support, and provide ECMO education for the many
clinical services involved in the care of ECMO pts
o varies among ECMO institutions
List the indications for conditions: MAS, RDS, sepsis, CDH, and PPHN
initiating ECMO
o blood's natural reaction is to activate coagulation
Describe the reason ECMO when exposed to the nonbiologic surfaces of the
patients need to be cannulas and circuit.
anticoagulated - anticoagulation is essential prior to cannula insertion
and throughout the ECMO course
o Vent settings should be lowered considerably to allow
the lungs to recover
Discuss the significance of
o Adjustments in ventilator support is necessary to
ventilatory support during
avoid hyper and hypoventilation
ECMO management
o Gradually weaned to "rest settings": are intended to
minimize lung trauma while avoiding atelectasis
, o Daily assessments
o Resolution of the problem
o Consider if risks outweigh the benefits
Discuss when and how to
o Assess lung and heart functions
wean off ECMO
o Ventilator support adjustment during weaning
o Post decannulation anticoagulation is most often
discontinued or adjusted to desired levels
meconium aspiration
respiratory distress syndrome
sepsis
Indications for ECMO?
pneumonia
congenital diaphragmatic hernia
primary pulmonary hypertension
- venoarterial (VA)
What are various types of - venovenous (VV)
EMCO? - extracorporeal CO2 removal (ECCO2R)
- hybrid
- maximum conventional support has not been
successful in delivering O2, removing CO2, or providing
adequate cardiac function
Why do we use ECMO?
- life-saving support for the most severe forms of acute
(Conventional support)
heart and/or lung failure
- allows the heart and/or lungs to rest and help avoid
the injury from mechanical ventilation
- lethal congenital anomalies
Absolute contraindications
- severe irreversible brain damage
for ECMO: newborn
- grade III or higher intracranial hemorrhage (ICH)
- birth weight less than 2 kg
- gestational age less than 34 weeks
- irreversible organ damage (unless a transplant
Relative contraindications
candidate)
for ECMO: newborn
- mechanical ventilation for greater than 10-14 days
- disease states with high probability of a poor
prognosis
added along tubing for infusing meds in pts who have
Infusion ports can be used limited IV access
for - option for access when continuous veno-venous
hemofiltration (CVVH) is required
How is ECMO powered? the blood pump
Fully Explained Solutions
Save
Terms in this set (60)
o to deliver adequate amounts of oxygen, and remove
carbon dioxide while the lungs and/or heart recover, or
Describe the primary goals
in some cases until the lungs or heart can be
of extracorporeal
transplanted
membrane oxygenation
o And in cases of VA ECMO, provide hemodynamic
support
o have a strong science background, a thorough
understanding of cardiopulmonary physiology, and the
ability to handle and manage highly technical
Describe the respiratory
equipment
therapist's role as an ECMO
o provide hour-to-hour management of the ECMO
specialist
support, and provide ECMO education for the many
clinical services involved in the care of ECMO pts
o varies among ECMO institutions
List the indications for conditions: MAS, RDS, sepsis, CDH, and PPHN
initiating ECMO
o blood's natural reaction is to activate coagulation
Describe the reason ECMO when exposed to the nonbiologic surfaces of the
patients need to be cannulas and circuit.
anticoagulated - anticoagulation is essential prior to cannula insertion
and throughout the ECMO course
o Vent settings should be lowered considerably to allow
the lungs to recover
Discuss the significance of
o Adjustments in ventilator support is necessary to
ventilatory support during
avoid hyper and hypoventilation
ECMO management
o Gradually weaned to "rest settings": are intended to
minimize lung trauma while avoiding atelectasis
, o Daily assessments
o Resolution of the problem
o Consider if risks outweigh the benefits
Discuss when and how to
o Assess lung and heart functions
wean off ECMO
o Ventilator support adjustment during weaning
o Post decannulation anticoagulation is most often
discontinued or adjusted to desired levels
meconium aspiration
respiratory distress syndrome
sepsis
Indications for ECMO?
pneumonia
congenital diaphragmatic hernia
primary pulmonary hypertension
- venoarterial (VA)
What are various types of - venovenous (VV)
EMCO? - extracorporeal CO2 removal (ECCO2R)
- hybrid
- maximum conventional support has not been
successful in delivering O2, removing CO2, or providing
adequate cardiac function
Why do we use ECMO?
- life-saving support for the most severe forms of acute
(Conventional support)
heart and/or lung failure
- allows the heart and/or lungs to rest and help avoid
the injury from mechanical ventilation
- lethal congenital anomalies
Absolute contraindications
- severe irreversible brain damage
for ECMO: newborn
- grade III or higher intracranial hemorrhage (ICH)
- birth weight less than 2 kg
- gestational age less than 34 weeks
- irreversible organ damage (unless a transplant
Relative contraindications
candidate)
for ECMO: newborn
- mechanical ventilation for greater than 10-14 days
- disease states with high probability of a poor
prognosis
added along tubing for infusing meds in pts who have
Infusion ports can be used limited IV access
for - option for access when continuous veno-venous
hemofiltration (CVVH) is required
How is ECMO powered? the blood pump
