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Mechanical Circulatory Support & ECMO Management Flashcards

7 cards from real CCP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. What is the primary indication for veno-arterial (VA) ECMO in the cardiac surgical setting?

    Answer: Cardiogenic shock with refractory hemodynamic instability

    VA-ECMO provides both cardiac output support and gas exchange, making it the appropriate intervention for cardiogenic shock when conventional therapies fail.

  2. In peripheral VA-ECMO, oxygenated blood is returned to which vessel?

    Answer: Femoral artery

    In peripheral VA-ECMO, the oxygenated blood is returned via the femoral artery so it enters the systemic arterial circulation to perfuse the body.

  3. What is the typical activated clotting time (ACT) target range maintained during ECMO support?

    Answer: 160–200 seconds

    During ECMO, the ACT is typically maintained at 160–200 seconds, which provides adequate anticoagulation to prevent circuit thrombosis while minimizing bleeding risk.

  4. Which complication arises specifically from the retrograde aortic flow generated by femoral VA-ECMO?

    Answer: Left ventricular distension

    Retrograde femoral arterial return increases left ventricular afterload; if the native heart cannot eject effectively, the LV becomes distended, raising wall stress and myocardial oxygen demand.

  5. In the context of mechanical circulatory support, what does a 'bridge to transplant' (BTT) strategy mean?

    Answer: Temporary support to stabilize a patient until a donor organ becomes available

    BTT refers to using temporary mechanical support (such as ECMO or an LVAD) to keep a patient hemodynamically stable until a suitable cardiac donor organ is available.

  6. Veno-venous (VV) ECMO is specifically indicated for which clinical scenario?

    Answer: Severe respiratory failure with preserved cardiac function

    VV-ECMO cannulates only the venous system to oxygenate and decarbonate blood, relying entirely on the native heart for circulation, making it appropriate when cardiac function is preserved.

  7. Which finding most reliably indicates successful weaning from VA-ECMO support?

    Answer: Stable hemodynamics as ECMO flows are progressively reduced

    Successful weaning is confirmed when the patient maintains adequate blood pressure and cardiac output as ECMO flows are gradually lowered, demonstrating that native cardiac function has recovered.