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ECMO Weaning & Decannulation 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.

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  1. The 'ECMO-off' test in VV ECMO involves which specific maneuver?

    Answer: Clamping both the drainage and return limbs with the circuit recirculating for 5–10 minutes while monitoring gases

    Clamping both ECMO limbs while recirculating allows assessment of native lung gas exchange without any ECMO support for a brief trial period.

  2. Which ventilator strategy is recommended before attempting VV ECMO weaning to protect the recovering lung?

    Answer: High PEEP and low tidal volume (lung-protective ventilation)

    Lung-protective ventilation with low tidal volumes and appropriate PEEP should be confirmed adequate before and during weaning to prevent re-injury.

  3. After successful ECMO weaning, anticoagulation is typically:

    Answer: Transitioned to prophylactic dosing or bridged to oral anticoagulation based on indication

    Post-decannulation anticoagulation is individualized — prophylactic dosing or bridging to oral agents is common depending on thrombosis risk and bleeding history.

  4. What echo parameter during a VA ECMO weaning trial at 1 L/min flow best predicts successful decannulation?

    Answer: LVEF > 35% and LVOT VTI > 12 cm

    LVEF > 35% combined with LVOT VTI > 12 cm at minimal ECMO support correlates with sufficient cardiac recovery for decannulation.

  5. Which parameter indicates successful weaning from neonatal VV ECMO in a term infant?

    Answer: PaO2 > 60 mmHg on FiO2 0.4 with sweep gas off

    Maintaining PaO2 > 60 mmHg on FiO2 ≤ 0.4 with sweep gas turned off demonstrates sufficient native lung recovery in neonates.

  6. Which surgical technique is used for decannulation when the femoral artery requires patch repair?

    Answer: Vein patch angioplasty or synthetic patch closure to prevent stenosis

    When primary closure would narrow the femoral artery, vein patch angioplasty or a synthetic patch is used to maintain vessel patency.