ECMO SPECIALIST EXAM QUESTIONS AND
ANSWERS
VV ECMO - Correct Answers -Can be though of as "IV gas exchange" aims to deliver
enough oxygen to support end-organ perfusion.
ECMO directors - Correct Answers -Dr. Devaleria & Dr. Sen
Extracorporeal Life Support Organization (ELSO) - Correct Answers -A Consortium
developed in 1989 that defines ECMO guidelines and maintains a registry of all ECMO
patients
Contraindications to V-V ECMO - Correct Answers -Cardiogenic Shock, chronic
respiratory failure, uncontrolled sepsis and multi-organ failure
Father of ECMO? What does he believe? - Correct Answers -Dr Robert Bartlett; he
believes al patients should have a Hgb of 15g/dL
An increase in this hemodynamic will decrease ECBF when using a centrifugal pump -
Correct Answers -afterload
This trending tool measures tissue and cerebral oximetry - Correct Answers -Near
Infrared Spectroscopy (NIRS)
These are the two methods for limb protection in peripheral V-A ECMO - Correct
Answers -Distal Perfusion Catheter and Hemashield graft
Test to confirm Hemolysis - Correct Answers -lactate dehydrogenase (LDH) and plasma
free Hemoglobin (sent out ever 3 days plasma free hgb)
Air Entrainment - Correct Answers -This originates from the pre-pump side of the circuit,
will seize a centrifugal pump, and requires rapid assessment for the source. Specialist
much watch closely, and prepare to clamp oxygenator outflow (ECMO Arterial)
Chatter - Correct Answers -This colloquialism is intermittent venous line obstruction that
causes variable ECBF (Ecmo Cannula bloodflow).
Arterial Decannulation - Correct Answers -This Emergency will result in rapid
exsanguination, Clamp the outflow immediately
, Low Flow/No Flow - Correct Answers -The inability of the centrifugal pump to generate
output. Remedied by reducing pump speed.
VV ECMO blood gas optimization is titrated according to - Correct Answers -Pt.'s
arterial blood gas
Signs of Oxygenator Failure - Correct Answers -increasing Delta P
increasing ECMO PCO2 despite increased sweep on blender
Decreasing ECMO PO2 despite increased FIO2 on the blender
Bioderm Cath Grips and CHG Tegaderm are changed? - Correct Answers -Every 7
days
Hourly ECMO monitoring and Assessment Requirements include - Correct Answers -
Circuit check
Cannulae site assessment
Circuit pressure /flow/blender settings
N/V assessment of cannulated limbs.
Type and screen - Correct Answers -This is done every 3 days and must remain up to
date entire time patient is on ECLS
Roller Pump - Correct Answers -Has no sensitivity to afterload
What directly controls CO2 removal and FIO2 - Correct Answers -Air/ oxygen gas
blender
Centrifugal pumps - Correct Answers -Hardware that provides laminar flow, it is preload
dependent, and afterload sensitive
What ECMO access is ideal for mobilization, susceptible to malposition, and more
technically difficult to place. - Correct Answers -Dual lumen /bicaval cannula (aka
Crescent/ Avalon)
This substance coats the hollow fibers mats of the oxygenator, which has enabled
ECMO runs to be prolonged while minimizing plasma leakage.: - Correct Answers -
Polymethylpentene (PMP)
Carbon dioxide - Correct Answers -Carried in blood bound to hemoglobins, as
bicarbonate ion, and is dissolved in plasma
ECMO Shunt is - Correct Answers -This inefficiency of V-V ECMO is lack of functional
ECMO blood flow compared to the patients native cardiac output resulting in a
decreased Sa02
ANSWERS
VV ECMO - Correct Answers -Can be though of as "IV gas exchange" aims to deliver
enough oxygen to support end-organ perfusion.
ECMO directors - Correct Answers -Dr. Devaleria & Dr. Sen
Extracorporeal Life Support Organization (ELSO) - Correct Answers -A Consortium
developed in 1989 that defines ECMO guidelines and maintains a registry of all ECMO
patients
Contraindications to V-V ECMO - Correct Answers -Cardiogenic Shock, chronic
respiratory failure, uncontrolled sepsis and multi-organ failure
Father of ECMO? What does he believe? - Correct Answers -Dr Robert Bartlett; he
believes al patients should have a Hgb of 15g/dL
An increase in this hemodynamic will decrease ECBF when using a centrifugal pump -
Correct Answers -afterload
This trending tool measures tissue and cerebral oximetry - Correct Answers -Near
Infrared Spectroscopy (NIRS)
These are the two methods for limb protection in peripheral V-A ECMO - Correct
Answers -Distal Perfusion Catheter and Hemashield graft
Test to confirm Hemolysis - Correct Answers -lactate dehydrogenase (LDH) and plasma
free Hemoglobin (sent out ever 3 days plasma free hgb)
Air Entrainment - Correct Answers -This originates from the pre-pump side of the circuit,
will seize a centrifugal pump, and requires rapid assessment for the source. Specialist
much watch closely, and prepare to clamp oxygenator outflow (ECMO Arterial)
Chatter - Correct Answers -This colloquialism is intermittent venous line obstruction that
causes variable ECBF (Ecmo Cannula bloodflow).
Arterial Decannulation - Correct Answers -This Emergency will result in rapid
exsanguination, Clamp the outflow immediately
, Low Flow/No Flow - Correct Answers -The inability of the centrifugal pump to generate
output. Remedied by reducing pump speed.
VV ECMO blood gas optimization is titrated according to - Correct Answers -Pt.'s
arterial blood gas
Signs of Oxygenator Failure - Correct Answers -increasing Delta P
increasing ECMO PCO2 despite increased sweep on blender
Decreasing ECMO PO2 despite increased FIO2 on the blender
Bioderm Cath Grips and CHG Tegaderm are changed? - Correct Answers -Every 7
days
Hourly ECMO monitoring and Assessment Requirements include - Correct Answers -
Circuit check
Cannulae site assessment
Circuit pressure /flow/blender settings
N/V assessment of cannulated limbs.
Type and screen - Correct Answers -This is done every 3 days and must remain up to
date entire time patient is on ECLS
Roller Pump - Correct Answers -Has no sensitivity to afterload
What directly controls CO2 removal and FIO2 - Correct Answers -Air/ oxygen gas
blender
Centrifugal pumps - Correct Answers -Hardware that provides laminar flow, it is preload
dependent, and afterload sensitive
What ECMO access is ideal for mobilization, susceptible to malposition, and more
technically difficult to place. - Correct Answers -Dual lumen /bicaval cannula (aka
Crescent/ Avalon)
This substance coats the hollow fibers mats of the oxygenator, which has enabled
ECMO runs to be prolonged while minimizing plasma leakage.: - Correct Answers -
Polymethylpentene (PMP)
Carbon dioxide - Correct Answers -Carried in blood bound to hemoglobins, as
bicarbonate ion, and is dissolved in plasma
ECMO Shunt is - Correct Answers -This inefficiency of V-V ECMO is lack of functional
ECMO blood flow compared to the patients native cardiac output resulting in a
decreased Sa02
