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ECMO Specialist Exam Questions and Answers New Version with complete solution
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ECMO Specialist Exam Questions and Answers New Version with complete solution
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ECMO Specialist Exam Questions and Answers New Version with complete solutionHow to recognize cardiogenic shock? (acronym) - CS-MODE Cardiac Rhythm SBP <90 Markers- cardiac Output- oliguria Drips - Inotropes/ pressers Exam - cool, clammy, resp distress
How to diagnose shock ( acronym) - (ECLS )
ECG Consult- surgeon Labs- lactates, abgs etc. Swan catheter
what is PAPI score? Formula and normal value - differentiates between the LV/RV disfunction, if low = RV dysfunction PAPi= (sPAP-dPAP)/RA
it is the pa sys - the pa dyastolic / right atrial pressure- can get these numbers from swan normal is >1.0
Formula for cardiac power output (CPO) and normal value - CPO= MAP x CO/451 normal = 0.7 to 1 W
what are the three key measurements for cardiogenic shock? - PAPI
CPO Lactate
what is cardiac power output? - amount of energy available to maintain the perfusion of the vital organs in shock
what does lactate in the blood mean and normal value? - anerobic metabolism is occurring normal is 0.9 to 1.7 what are the two goals of mechanical circulatory support? - restore adequate end organ perfusion ventricular unloading
how does the impella CP work as an LV vent? - drains at LV and returns at the aortic arch provides 3-3.5 LPM of flow
what are the 5 factors affecting pharmacokinetics with critical illness? - 1. augmented cardiac output
2. leaky capillaries 3. volume resusitation 4. end-organ perfusion 5. altered protein binding
what is pharmacodynamics? - the bodys biological response to the drug
what are the factors 5 affecting pharmacokinetics with ECMO? - 1. augmented cardiac output 2. leaky capillaries 3. end-organ perfusion 4. hemodilution 5. drug sequestration
which drugs should you avoid with ecmo? - benzos!!! lipophillic and sequester in the tubing
why do we need anticoagulation on ecmo? - blood contacts the ecmo circuit causing a sirs response and leads to: inflammation/vasodilation coagulation altered fibrinolysis
how does heparin work? - Activates antithrombin III -> inactivates thrombin, factor IXa, & factor Xa.
what are the 3 definitions of ards and how are they defined? - 1. Mild- pf ratio is 200-
300 mmhg w/peep or CPAP > 5 2. moderate - pf ratio is 100 - 200 mmhg w/ peep or CPAP > 5 3. severe- pf ratio is <100 mmhg with peep > 5
what are the 3 consequences of lung injury with ards? - 1. impaired gas exchange 2. decreased compliance 3. increased pulmonary arterial pressure
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