ECMO SPECIALIST EXAM QUESTIONS
AND ANSWERS ALL CORRECT
What two insertion kits are there and what is the difference in the two? - Answer- PIK-A
and PIK-V - both are J tip wires
A- 100 cm arterial
V- 150 cm venous
How much heparin do you give once both wires are in? - Answer- 5,000 units
What do you verbalize at bedside before flowing during insertion? - Answer- Both hands
on cannulas
What is the type and size of arterial cannula? - Answer- bullet tip return, common is 21
F but can be 19-25 F
non bullet tip return is 19 F
What is the type and size of venous cannula? - Answer- multi stage drainage, common
is 25 F but can be 21-29 F
What is the role of SVO2? - Answer- measures global oxygen consumption and
utilization by the body normal is 65-75%
What happens with an Sv02 of less than 50%? - Answer- anerobic metabolism and
lactic acid production
What is the formula for content of arterial oxygen? - Answer- CaO2 = (hgb x 1.34) x
SaO2) + (PaO2 x 0.003)
normal = 20 ml/dl
what is the formula for oxygen delivery? - Answer- DO2= CaO2 x CO x 10
normal = 1000 ml/min
How to recognize cardiogenic shock? (acronym) - Answer- CS-MODE
Cardiac Rhythm
SBP <90
Markers- cardiac
Output- oliguria
, Drips - Inotropes/ pressers
Exam - cool, clammy, resp distress
How to diagnose shock ( acronym) - Answer- (ECLS )
ECG
Consult- surgeon
Labs- lactates, abgs etc.
Swan catheter
what is PAPI score? Formula and normal value - Answer- 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
Formula for cardiac power output (CPO) and normal value - Answer- CPO= MAP x
CO/451
normal = 0.7 to 1 W
what are the three key measurements for cardiogenic shock? - Answer- PAPI
CPO
Lactate
what is cardiac power output? - Answer- amount of energy available to maintain the
perfusion of the vital organs in shock
what does lactate in the blood mean and normal value? - Answer- anerobic metabolism
is occurring
normal is 0.9 to 1.7
what are the two goals of mechanical circulatory support? - Answer- restore adequate
end organ perfusion
ventricular unloading
how does the impella CP work as an LV vent? - Answer- drains at LV and returns at the
aortic arch
provides 3-3.5 LPM of flow
what are the 5 factors affecting pharmacokinetics with critical illness? - Answer- 1.
augmented cardiac output
AND ANSWERS ALL CORRECT
What two insertion kits are there and what is the difference in the two? - Answer- PIK-A
and PIK-V - both are J tip wires
A- 100 cm arterial
V- 150 cm venous
How much heparin do you give once both wires are in? - Answer- 5,000 units
What do you verbalize at bedside before flowing during insertion? - Answer- Both hands
on cannulas
What is the type and size of arterial cannula? - Answer- bullet tip return, common is 21
F but can be 19-25 F
non bullet tip return is 19 F
What is the type and size of venous cannula? - Answer- multi stage drainage, common
is 25 F but can be 21-29 F
What is the role of SVO2? - Answer- measures global oxygen consumption and
utilization by the body normal is 65-75%
What happens with an Sv02 of less than 50%? - Answer- anerobic metabolism and
lactic acid production
What is the formula for content of arterial oxygen? - Answer- CaO2 = (hgb x 1.34) x
SaO2) + (PaO2 x 0.003)
normal = 20 ml/dl
what is the formula for oxygen delivery? - Answer- DO2= CaO2 x CO x 10
normal = 1000 ml/min
How to recognize cardiogenic shock? (acronym) - Answer- CS-MODE
Cardiac Rhythm
SBP <90
Markers- cardiac
Output- oliguria
, Drips - Inotropes/ pressers
Exam - cool, clammy, resp distress
How to diagnose shock ( acronym) - Answer- (ECLS )
ECG
Consult- surgeon
Labs- lactates, abgs etc.
Swan catheter
what is PAPI score? Formula and normal value - Answer- 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
Formula for cardiac power output (CPO) and normal value - Answer- CPO= MAP x
CO/451
normal = 0.7 to 1 W
what are the three key measurements for cardiogenic shock? - Answer- PAPI
CPO
Lactate
what is cardiac power output? - Answer- amount of energy available to maintain the
perfusion of the vital organs in shock
what does lactate in the blood mean and normal value? - Answer- anerobic metabolism
is occurring
normal is 0.9 to 1.7
what are the two goals of mechanical circulatory support? - Answer- restore adequate
end organ perfusion
ventricular unloading
how does the impella CP work as an LV vent? - Answer- drains at LV and returns at the
aortic arch
provides 3-3.5 LPM of flow
what are the 5 factors affecting pharmacokinetics with critical illness? - Answer- 1.
augmented cardiac output
