Exam (elaborations)
ECMO PATIENT MANAGEMENT EXAM LATEST UPDATE
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ECMO PATIENT MANAGEMENT EXAM LATEST UPDATE...
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ECMO PATIENT MANAGEMENT EXAMLATEST UPDATE
Common NICU illnesses needing ECMO include CDH, PPHN, sepsis, and others*.
Common PICU diagnoses that require ECMO - ANSWER Respiratory failure,
sepsis, ARDS, COVID, HUS, asthmatics, acute chest, and other*
Common CVICU diagnoses that require ECMO - ANSWER Myocarditis,
post-cardiac surgery, cardiomyopathy, PHTN, arrhythmia, and sepsis
What does it imply to have reached the maximum level of medical management? -
ANSWER All traditional medical therapies were offered.
When picking between VA and VV ECMO, what factors should be considered? -
ANSWER THE PATIENT'S NEEDS... CO2 removal, oxygen delivery, or both?
VA ECMO indications: necessary for cardiac support; appropriate for respiratory
assistance.
VA ECMO replaces both heart and lung function by artificial methods.
VA ECMO increases: - natural cardiac output.
VA ECMO technique: - Answer: open technique/central cannulation.
VV ECMO indications: ANSWER respiratory disease, viral illness, low to no need
for blood pressure support.
, What could be the problem with VV ECMO? - Answer recirculation.
VV ECMO technique: - ANSWER does not sacrifice major arteries like VA; can
be done percutaneously; semi-open technique.
What should the ECMO Specialist do to prepare for ECMO? - ANSWER collect
supplies, provide access to blood products, examine patient lab results, and assist
the primer as required.
NICU resting vent settings: ANSWER PC 22/5 f24 PS 5 40%.
PICU resting vent settings: - ANSWER f6-10, VC or PC, increased PEEP, 40%
What may the CXR reveal after 2-3 days of respiratory ECMO? - ANSWER
"whiteout"
ABGs should be completed: - ANSWER Q6H and PRN, with modifications.
Preox VBG-HbO2 (pump venous) intervals: - Answer Q12H for SvO2 calibration
and CO2 removal.
Post-operative ABG (pump arterial) interval: - ANSWER QDay and PRN for
oxygenator operation
What are some respiratory toilet recommendations for patients on ECMO? -
ANSWER CPT, bag and sx, SMI, IPV, mucolytics, bronchoscopy; adjust ETT as
needed.
Mixed venous saturation goals: - ANSWER: 65–80%
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