ECMO STUDY QUESTIONS WITH
CORRECT ANSWERS
What are 3 factors that affect oxygen delivery? - Correct Answers -- Hemoglobin
- Cardiac Output / ECMO flow
- Oxygen saturation
Key term for VA-ECMO? - Correct Answers -Partial bypass
Key term for VV-ECMO? - Correct Answers -Partial capture
On which type of ECMO do you run a full code (with compression)? - Correct Answers -
VV-ECMO
Which ECMO requires full drugs per ACLS but no compressions in a code? - Correct
Answers -VA-ECMO
mL in an ECMO circuit? - Correct Answers -800mL
mL in an ECMO circuit + CVVHD? - Correct Answers -1100mL
What are the actions of heparin? - Correct Answers -- Accelerates the action of
endogenous antithrombin.
- Inhibits thrombin and factor Xa
What is the normal dose of heparin given at the time of ECMO cannulation? - Correct
Answers -50 - 100 units / kg
What blood product is indicated for patients who are heparin resistant 2/2 diminshed
antithrombin levels? - Correct Answers -FFP
In which type of ECMO is SvO2 utilized? - Correct Answers -VA-ECMO
What are the "3 C's" in an ECMO emergency? - Correct Answers -- Clamp
- Call for help
- Compensate for losses in support with drugs and other measures
What is the default anticoagulant used in ECLS? - Correct Answers -Heparin
What is the standard goal aPTT for ECMO patients being heparinized? - Correct
Answers -50 - 75
, Clotting that occurs when blood comes into contact with a non-endothelial surface -
Correct Answers -Intrinsic pathway
Clotting that occurs by the release of tissue factor from damaged tissue - Correct
Answers -Extrinsic pathway
Current survivial rate of patients put on ECMO for cardiac reasons? - Correct Answers -
23 - 71%
What are some contraindications to ECMO? - Correct Answers -- End-stage,
irreversible, or inoperable cardiac disease.
- Significant neurological or end-stage renal impairment.
- Uncontrolled bleeding of major organs.
- Extremes of size or weight (relative)
- Inaccessible vessels during CPR (though femoral is usually accessible)
Placement options for venous drainage of VV-ECMO? - Correct Answers -- Femoral
Vein
- R IJ (if an Avalon Cannula)
Both drain venous blood from the SVC
Placement options for return blood of VV-ECMO? - Correct Answers -- Right IJ
- Right Axillary vein
- Right Subclavian vein
All terminate in the RA with the outflow directed at the Tricuspid valve.
What percentage of cardiac output is provided by VV-ECMO? - Correct Answers -0%
What percentage of cardiac output can be provided by VA-ECMO? - Correct Answers -
60 - 80%
Cannulation sites for venous drainage in VA-ECMO? - Correct Answers -- Femoral vein
- Right IJ
Both terminate in the SVC
Cannulation sites for arterial (return) cannula? - Correct Answers -- Femoral artery
- Axillary artery
- Carotid artery
- Transthoracic (direct) cannulation
When "resting the lungs" with VV-ECMO, what are common ventilator settings? -
Correct Answers -RR <10 (We will allow permissive hypercapnea while resting)
CORRECT ANSWERS
What are 3 factors that affect oxygen delivery? - Correct Answers -- Hemoglobin
- Cardiac Output / ECMO flow
- Oxygen saturation
Key term for VA-ECMO? - Correct Answers -Partial bypass
Key term for VV-ECMO? - Correct Answers -Partial capture
On which type of ECMO do you run a full code (with compression)? - Correct Answers -
VV-ECMO
Which ECMO requires full drugs per ACLS but no compressions in a code? - Correct
Answers -VA-ECMO
mL in an ECMO circuit? - Correct Answers -800mL
mL in an ECMO circuit + CVVHD? - Correct Answers -1100mL
What are the actions of heparin? - Correct Answers -- Accelerates the action of
endogenous antithrombin.
- Inhibits thrombin and factor Xa
What is the normal dose of heparin given at the time of ECMO cannulation? - Correct
Answers -50 - 100 units / kg
What blood product is indicated for patients who are heparin resistant 2/2 diminshed
antithrombin levels? - Correct Answers -FFP
In which type of ECMO is SvO2 utilized? - Correct Answers -VA-ECMO
What are the "3 C's" in an ECMO emergency? - Correct Answers -- Clamp
- Call for help
- Compensate for losses in support with drugs and other measures
What is the default anticoagulant used in ECLS? - Correct Answers -Heparin
What is the standard goal aPTT for ECMO patients being heparinized? - Correct
Answers -50 - 75
, Clotting that occurs when blood comes into contact with a non-endothelial surface -
Correct Answers -Intrinsic pathway
Clotting that occurs by the release of tissue factor from damaged tissue - Correct
Answers -Extrinsic pathway
Current survivial rate of patients put on ECMO for cardiac reasons? - Correct Answers -
23 - 71%
What are some contraindications to ECMO? - Correct Answers -- End-stage,
irreversible, or inoperable cardiac disease.
- Significant neurological or end-stage renal impairment.
- Uncontrolled bleeding of major organs.
- Extremes of size or weight (relative)
- Inaccessible vessels during CPR (though femoral is usually accessible)
Placement options for venous drainage of VV-ECMO? - Correct Answers -- Femoral
Vein
- R IJ (if an Avalon Cannula)
Both drain venous blood from the SVC
Placement options for return blood of VV-ECMO? - Correct Answers -- Right IJ
- Right Axillary vein
- Right Subclavian vein
All terminate in the RA with the outflow directed at the Tricuspid valve.
What percentage of cardiac output is provided by VV-ECMO? - Correct Answers -0%
What percentage of cardiac output can be provided by VA-ECMO? - Correct Answers -
60 - 80%
Cannulation sites for venous drainage in VA-ECMO? - Correct Answers -- Femoral vein
- Right IJ
Both terminate in the SVC
Cannulation sites for arterial (return) cannula? - Correct Answers -- Femoral artery
- Axillary artery
- Carotid artery
- Transthoracic (direct) cannulation
When "resting the lungs" with VV-ECMO, what are common ventilator settings? -
Correct Answers -RR <10 (We will allow permissive hypercapnea while resting)
