ECMO Complications & Management Flashcards
6 cards from real CES practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 ECMO Complications & Management flashcards as text
Harlequin syndrome (differential hypoxia) occurs in which ECMO configuration?
Answer: Peripheral VA ECMO with femoral cannulation and recovering cardiac function
Harlequin syndrome occurs in peripheral VA ECMO when the recovering heart ejects deoxygenated blood into the aorta, competing with retrograde oxygenated ECMO flow.
What is the best monitoring strategy to detect Harlequin syndrome early?
Answer: Right-hand (pre-ductal) pulse oximetry combined with arterial blood gas from the right radial artery
Right radial arterial ABG and right-hand SpO2 reflect the coronary and cerebral circulation, revealing upper body hypoxia in Harlequin syndrome.
Neurological complications are most common in which ECMO patient population?
Answer: Neonates on VA ECMO
Neonates on VA ECMO have the highest rates of neurological complications including IVH, stroke, and seizures due to their vulnerable developing brains.
Acute hemolysis on ECMO is best indicated by which laboratory finding?
Answer: Rising LDH and plasma-free hemoglobin > 50 mg/dL
Elevated LDH and plasma-free hemoglobin above 50 mg/dL are the hallmark laboratory indicators of significant hemolysis in ECMO circuits.
Chatter (vibration/cavitation) in the drainage tubing most commonly indicates:
Answer: Hypovolemia or high resistance at the drainage cannula causing inlet suction
Drainage tubing chatter reflects excessive inlet suction, typically caused by hypovolemia, cannula malposition, or high drainage resistance.
The most common infectious complication in ECMO patients is:
Answer: Ventilator-associated pneumonia
Ventilator-associated pneumonia (VAP) remains the most frequent infection complication in ECMO patients due to prolonged mechanical ventilation requirements.