ECMO Specialist Exam Guide 2026: Practice
Questions & Answers
How to recognize cardiogenic shock? (acronym)
CS-MODE
Cardiac Rhythm
SBP <90
Markers- cardiac
Output- oliguria
Drips - Inotropes/ pressers
Exam - cool, clammy, resp distress
How to diagnose shock ( acronym)
(ECLS )
ECG
Consult- surgeon
Labs- lactates, abgs etc.
Swan catheter
what is PAPI score? Formula and normal value
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
CPO= MAP x CO/451
normal = 0.7 to 1 W
what are the three key measurements for cardiogenic shock?
PAPI
CPO
Lactate
, what is cardiac power output?
amount of energy available to maintain the perfusion of the vital organs in shock
what does lactate in the blood mean and normal value?
anerobic metabolism is occurring
normal is 0.9 to 1.7
what are the two goals of mechanical circulatory support?
restore adequate end organ perfusion
ventricular unloading
how does the impella CP work as an LV vent?
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?
1. augmented cardiac output
2. leaky capillaries
3. volume resusitation
4. end-organ perfusion
5. altered protein binding
what is pharmacodynamics?
the bodys biological response to the drug
what are the factors 5 affecting pharmacokinetics with ECMO?
1. augmented cardiac output
2. leaky capillaries
3. end-organ perfusion
4. hemodilution
5. drug sequestration
which drugs should you avoid with ecmo?
Questions & Answers
How to recognize cardiogenic shock? (acronym)
CS-MODE
Cardiac Rhythm
SBP <90
Markers- cardiac
Output- oliguria
Drips - Inotropes/ pressers
Exam - cool, clammy, resp distress
How to diagnose shock ( acronym)
(ECLS )
ECG
Consult- surgeon
Labs- lactates, abgs etc.
Swan catheter
what is PAPI score? Formula and normal value
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
CPO= MAP x CO/451
normal = 0.7 to 1 W
what are the three key measurements for cardiogenic shock?
PAPI
CPO
Lactate
, what is cardiac power output?
amount of energy available to maintain the perfusion of the vital organs in shock
what does lactate in the blood mean and normal value?
anerobic metabolism is occurring
normal is 0.9 to 1.7
what are the two goals of mechanical circulatory support?
restore adequate end organ perfusion
ventricular unloading
how does the impella CP work as an LV vent?
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?
1. augmented cardiac output
2. leaky capillaries
3. volume resusitation
4. end-organ perfusion
5. altered protein binding
what is pharmacodynamics?
the bodys biological response to the drug
what are the factors 5 affecting pharmacokinetics with ECMO?
1. augmented cardiac output
2. leaky capillaries
3. end-organ perfusion
4. hemodilution
5. drug sequestration
which drugs should you avoid with ecmo?
