CCP Mechanical Circulatory Support & ECMO Management

Question 1

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

Accepted Answer

Cardiogenic shock with refractory hemodynamic instability

Answer

Respiratory failure with normal cardiac function

Answer

Pulmonary hypertension without cardiac involvement

Answer

Chronic heart failure awaiting transplant evaluation

Question 2

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

Accepted Answer

Femoral artery

Answer

Superior vena cava

Answer

Pulmonary artery

Answer

Femoral vein

Question 3

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

Accepted Answer

160–200 seconds

Answer

80–120 seconds

Answer

300–350 seconds

Answer

400–450 seconds

Question 4

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

Accepted Answer

Left ventricular distension

Answer

Venous air embolism

Answer

Oxygenator membrane failure

Answer

Pulmonary edema from circuit overpressure

Question 5

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

Accepted Answer

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

Answer

Permanent cardiac replacement with a device

Answer

Weaning from mechanical ventilation using device support

Answer

Use of an IABP to treat massive pulmonary embolism

Question 6

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

Accepted Answer

Severe respiratory failure with preserved cardiac function

Answer

Cardiac failure with preserved pulmonary function

Answer

Combined cardiac and respiratory failure

Answer

Pulmonary hypertension requiring cardiac unloading

Question 7

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

Accepted Answer

Stable hemodynamics as ECMO flows are progressively reduced

Answer

Increasing ECMO flow requirements to maintain MAP

Answer

Rising SvO2 only at high ECMO flow rates

Answer

Decreasing arterial oxygen saturation with flow reduction