ECMO Specialist Practice Exam Questions
with Correct Answers
What is the hallmark symptom of ARDS? - Answer- decreased compliance
What blood vessel must the DPC sit in? - Answer- SFA
Consequences of lung injury include these three things - Answer- 1. Impaired gas
exchange
2. Decreased compliance
3. Increased pulmonary artery pressure
What is the first stage in ARDS? - Answer- Exudative Stage (4-7 days)
What happens in the exudative stage of ARDS? - Answer- -Interstitial and alveolar
edema
-Hyaline members (thickens alveolar wall, is reversible before 1 week)
-enhanced cytokine production
-loss of coagulation and fibrinolytic homeostasis
What is the second stage of ARDS? - Answer- Proliferative stage (> 7-21 days)
What happens in proliferative stage? - Answer- -alveolar and intimal fibrosis (irreversible
damage)
-proliferation of type II cells and fibroblasts
What is the third stage of ARDS? - Answer- fibrotic stage (> 21 days)
What happens in fibrotic stage? - Answer- -extensive pulmonary fibrosis
-loss of normal alveolar structure
-emphysematous lungs
Can pancreatitis cause ARDS? - Answer- yes because pancreas creates surfactant
When do you think about VV ECMO on ARDS patients? - Answer- P/F ratio < 80
What amount of tidal volume has been shown to have better clinical outcomes? -
Answer- 6 ml/kg
How much NS does it take to prime HLS? - Answer- 500 ml total
1 ft PVC 3/8 in tubing: 20 ml NS
, Cardiohelp oxy/pump: 273 ml
Quadrox oxy: 215 ml
Centrimag and Rotaflow pump: 32 ml
Lifespark pump: 16 ml
What is DO2? What four things controls DO2? - Answer- The amount of oxygen
delivered to the peripheral tissues every minute.
1. cardiac output
2. hgb concentration
3. hgb saturation
4. dissolved oxygen
DO2 formula - Answer- DO2 = CaO2 x CO x 10*
(10 is constant)
What is a normal DO2? - Answer- 1000 ml/min
What is VO2? - Answer- The amount of oxygen being consumed by the tissues each
minute.
What 3 things is VO2 determined by? - Answer- 1. cell metabolism (organ specific)
2. mass & activity
3. thyroid, hypothalamus, & catecholamines
What is the VO2 formula (oxygen consumption)?
What is a normal VO2? - Answer- VO2 = CO (SaO2 - SvO2) x Hgb x 1.34 x 10
200-250 ml/min
What factors increase oxygen utilization by tissues? - Answer- -surgical trauma
-organ failure
-sepsis (50-100%)
-not sedated head injury (138%)
-bath (23%)
-turning (31%)
What is SvO2? - Answer- Venous Oxygen Saturation
Measure of oxygen content of blood returning to the right side of the heart after
perfusing the entire body
Measures "GLOBAL" O2 consumption and what the body utilized
with Correct Answers
What is the hallmark symptom of ARDS? - Answer- decreased compliance
What blood vessel must the DPC sit in? - Answer- SFA
Consequences of lung injury include these three things - Answer- 1. Impaired gas
exchange
2. Decreased compliance
3. Increased pulmonary artery pressure
What is the first stage in ARDS? - Answer- Exudative Stage (4-7 days)
What happens in the exudative stage of ARDS? - Answer- -Interstitial and alveolar
edema
-Hyaline members (thickens alveolar wall, is reversible before 1 week)
-enhanced cytokine production
-loss of coagulation and fibrinolytic homeostasis
What is the second stage of ARDS? - Answer- Proliferative stage (> 7-21 days)
What happens in proliferative stage? - Answer- -alveolar and intimal fibrosis (irreversible
damage)
-proliferation of type II cells and fibroblasts
What is the third stage of ARDS? - Answer- fibrotic stage (> 21 days)
What happens in fibrotic stage? - Answer- -extensive pulmonary fibrosis
-loss of normal alveolar structure
-emphysematous lungs
Can pancreatitis cause ARDS? - Answer- yes because pancreas creates surfactant
When do you think about VV ECMO on ARDS patients? - Answer- P/F ratio < 80
What amount of tidal volume has been shown to have better clinical outcomes? -
Answer- 6 ml/kg
How much NS does it take to prime HLS? - Answer- 500 ml total
1 ft PVC 3/8 in tubing: 20 ml NS
, Cardiohelp oxy/pump: 273 ml
Quadrox oxy: 215 ml
Centrimag and Rotaflow pump: 32 ml
Lifespark pump: 16 ml
What is DO2? What four things controls DO2? - Answer- The amount of oxygen
delivered to the peripheral tissues every minute.
1. cardiac output
2. hgb concentration
3. hgb saturation
4. dissolved oxygen
DO2 formula - Answer- DO2 = CaO2 x CO x 10*
(10 is constant)
What is a normal DO2? - Answer- 1000 ml/min
What is VO2? - Answer- The amount of oxygen being consumed by the tissues each
minute.
What 3 things is VO2 determined by? - Answer- 1. cell metabolism (organ specific)
2. mass & activity
3. thyroid, hypothalamus, & catecholamines
What is the VO2 formula (oxygen consumption)?
What is a normal VO2? - Answer- VO2 = CO (SaO2 - SvO2) x Hgb x 1.34 x 10
200-250 ml/min
What factors increase oxygen utilization by tissues? - Answer- -surgical trauma
-organ failure
-sepsis (50-100%)
-not sedated head injury (138%)
-bath (23%)
-turning (31%)
What is SvO2? - Answer- Venous Oxygen Saturation
Measure of oxygen content of blood returning to the right side of the heart after
perfusing the entire body
Measures "GLOBAL" O2 consumption and what the body utilized
