ECMO

Question 1

What is the goal SAT for ecmo patient’s

Answer 1

88-92%

Question 2

V-V ECMO helps with _______ and avoids _______

Answer 2

Respiratory Failure and Barotrauma

Question 3

What type of ECMO do you not need compression for during code?

Answer 3

V-A ECMO

Question 4

What P/F ratio number is ECMO indicated at?

Answer 4

<100

Question 5

What is the ideal time to place someone on ECMO after they code?

Answer 5

within 23 minutes to a half an hour

Question 6

Ecmo allows the lungs to heal by avoiding______ and ______

Answer 6

High concentrations, High peak inspiratory pressures

Question 7

A non-occlusive pump is known as

Answer 7

Centrifugal

Question 8

Negative pressure is where in the circuit?

Answer 8

Drain line

Question 9

In Bi-fem VV ECMO the return Cannula is positioned where?

Answer 9

Higher

Question 10

What does a rising Delta P indicate?

Answer 10

Oxygenator failure

Question 11

If you want to lower the CO2 you need to do what?

Answer 11

Increase the sweep

Question 12

The more negative the pressure the higher risk for?

Answer 12

Hemolysis

Question 13

How do you calculate DELTA P?

Answer 13

Pre - Post pressure

Question 14

At what RPMS are you at risk for Hemolysis

Answer 14

> 4000

Question 15

Centrifugal pump is ____ and _____ dependent

Answer 15

Pre-load and afterload

Question 16

How is a cannula size selected?

Answer 16

Flow rate vs pressure loss

Question 17

What should the distance be between cannulas?

Answer 17

15 cm

Question 18

Recirculation is seen in ?

Answer 18

V-V ECMO

Question 19

Mixing cloud is known as and is seen in?

Answer 19

Differential Hypoxia and V-A ECMO

Question 20

Normal range of CO?

Answer 20

4-8

Question 21

How do you calculate CO?

Answer 21

HRxSV

Question 22

Normal range for cardiac index?

Answer 22

2.4-4

Question 23

How do you calculate CI?

Answer 23

CO/BSA

Question 24

How do you calculate patient target flow?

Answer 24

CIXBSA

Question 25

What is the oxygen binding capacity of HGB?

Answer 25

1.34

Question 26

DO2 is?

Answer 26

Rate of oxygen delivery in ml/min

Question 27

Measure of total body oxygenation/balance between O2 consumption and delivery?

Answer 27

SVo2

Question 28

A state of high extraction = a ____ SVO2 of <_____

Answer 28

Low and <65-75%

Question 29

Two Most frequent complications in ECMO?

Answer 29

Bleeding and thrombosis

Question 30

How do you replenish ATlll levels?

Answer 30

Fresh frozen plasma

Question 31

What is it called when after 4-5 days of heparin expose platelet count falls 50% below baseline

Answer 31

HIT or heparin induced thrombocytopenia

Question 32

What is the normal range for Anti-factor or ANTI-XA?

Answer 32

0.3 to 0.7

Question 33

Ranges for ACT?

Answer 33

180-220

Question 34

Ranges for PTT?

Answer 34

60-80

Question 35

Venous inlet pressures should be ___ than post membrane pressure

Answer 35

slightly greater.

Question 36

Pre/Posts arterial pressure should not exceed what? What is there a risk for?

Answer 36

300-350, hemolysis

Question 36

typical range of SVO2 on a premembrane blood gas

Answer 36

65-75%

Question 37

PO2 on a post membrane gas should be?

Answer 37

300-500mmHg

Question 38

Post membrane gas SAO2 should be?

Answer 38

98-100%

Question 39

the volume of blood in patient is known as?

Answer 39

Preload

Question 40

resitance in the patient that ecmo circuit has to overcome is known as?

Answer 40

Afterload

Question 41

3 causes of decrease in preload?

Answer 41

- bleeding/diuresis/dialysis -hypovolemia -mechanical obstruction (tension pneumo, tamponade, abdominal compartment syndrome)

Question 42

3 causes of increase in afterload

Answer 42

-increased systemic vascular resistance (hypertension) -kinking in circuit tubing -thrombus

Question 43

3 reasons to decrease ecmo blood flow rate?

Answer 43

- patient shows recovery/ability to oxygenate on own -hemolysis w/ high pressures/speed -chatter and flow rates are fluctuating/irregular

Question 44

2 reasons to increase ecmo blood flow rate

Answer 44

-signs of hypoxia/hypoxemia (decreased spo2 and/or pao2) -signsof decreased perfusion (elevated lactate)