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ECMO > ECMO > Flashcards

ECMO Flashcards

1
Q

What is the goal SAT for ecmo patient’s

A

88-92%

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2
Q

V-V ECMO helps with _______ and avoids _______

A

Respiratory Failure and Barotrauma

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3
Q

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

A

V-A ECMO

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4
Q

What P/F ratio number is ECMO indicated at?

A

<100

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5
Q

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

A

within 23 minutes to a half an hour

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6
Q

Ecmo allows the lungs to heal by avoiding______ and ______

A

High concentrations, High peak inspiratory pressures

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7
Q

A non-occlusive pump is known as

A

Centrifugal

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8
Q

Negative pressure is where in the circuit?

A

Drain line

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9
Q

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

A

Higher

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10
Q

What does a rising Delta P indicate?

A

Oxygenator failure

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11
Q

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

A

Increase the sweep

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12
Q

The more negative the pressure the higher risk for?

A

Hemolysis

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13
Q

How do you calculate DELTA P?

A

Pre - Post pressure

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14
Q

At what RPMS are you at risk for Hemolysis

A

> 4000

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15
Q

Centrifugal pump is ____ and _____ dependent

A

Pre-load and afterload

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16
Q

How is a cannula size selected?

A

Flow rate vs pressure loss

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17
Q

What should the distance be between cannulas?

A

15 cm

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18
Q

Recirculation is seen in ?

A

V-V ECMO

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19
Q

Mixing cloud is known as and is seen in?

A

Differential Hypoxia and V-A ECMO

20
Q

Normal range of CO?

A

4-8

21
Q

How do you calculate CO?

A

HRxSV

22
Q

Normal range for cardiac index?

A

2.4-4

23
Q

How do you calculate CI?

A

CO/BSA

24
Q

How do you calculate patient target flow?

A

CIXBSA

25
Q

What is the oxygen binding capacity of HGB?

A

1.34

26
Q

DO2 is?

A

Rate of oxygen delivery in ml/min

27
Q

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

A

SVo2

28
Q

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

A

Low and <65-75%

29
Q

Two Most frequent complications in ECMO?

A

Bleeding and thrombosis

30
Q

How do you replenish ATlll levels?

A

Fresh frozen plasma

31
Q

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

A

HIT or heparin induced thrombocytopenia

32
Q

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

A

0.3 to 0.7

33
Q

Ranges for ACT?

A

180-220

34
Q

Ranges for PTT?

A

60-80

35
Q

Venous inlet pressures should be ___ than post membrane pressure

A

slightly greater.

36
Q

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

A

300-350, hemolysis

36
Q

typical range of SVO2 on a premembrane blood gas

A

65-75%

37
Q

PO2 on a post membrane gas should be?

A

300-500mmHg

38
Q

Post membrane gas SAO2 should be?

A

98-100%

39
Q

the volume of blood in patient is known as?

A

Preload

40
Q

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

A

Afterload

41
Q

3 causes of decrease in preload?

A
  • bleeding/diuresis/dialysis
    -hypovolemia
    -mechanical obstruction (tension pneumo, tamponade, abdominal compartment syndrome)
42
Q

3 causes of increase in afterload

A

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

43
Q

3 reasons to decrease ecmo blood flow rate?

A
  • patient shows recovery/ability to oxygenate on own
    -hemolysis w/ high pressures/speed
    -chatter and flow rates are fluctuating/irregular
44
Q

2 reasons to increase ecmo blood flow rate

A

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

ECMO (1 decks)

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