ECMO Flashcards
What is the goal SAT for ecmo patient’s
88-92%
V-V ECMO helps with _______ and avoids _______
Respiratory Failure and Barotrauma
What type of ECMO do you not need compression for during code?
V-A ECMO
What P/F ratio number is ECMO indicated at?
<100
What is the ideal time to place someone on ECMO after they code?
within 23 minutes to a half an hour
Ecmo allows the lungs to heal by avoiding______ and ______
High concentrations, High peak inspiratory pressures
A non-occlusive pump is known as
Centrifugal
Negative pressure is where in the circuit?
Drain line
In Bi-fem VV ECMO the return Cannula is positioned where?
Higher
What does a rising Delta P indicate?
Oxygenator failure
If you want to lower the CO2 you need to do what?
Increase the sweep
The more negative the pressure the higher risk for?
Hemolysis
How do you calculate DELTA P?
Pre - Post pressure
At what RPMS are you at risk for Hemolysis
> 4000
Centrifugal pump is ____ and _____ dependent
Pre-load and afterload
How is a cannula size selected?
Flow rate vs pressure loss
What should the distance be between cannulas?
15 cm
Recirculation is seen in ?
V-V ECMO
Mixing cloud is known as and is seen in?
Differential Hypoxia and V-A ECMO
Normal range of CO?
4-8
How do you calculate CO?
HRxSV
Normal range for cardiac index?
2.4-4
How do you calculate CI?
CO/BSA
How do you calculate patient target flow?
CIXBSA
What is the oxygen binding capacity of HGB?
1.34
DO2 is?
Rate of oxygen delivery in ml/min
Measure of total body oxygenation/balance between O2 consumption and delivery?
SVo2
A state of high extraction = a ____ SVO2 of <_____
Low and <65-75%
Two Most frequent complications in ECMO?
Bleeding and thrombosis
How do you replenish ATlll levels?
Fresh frozen plasma
What is it called when after 4-5 days of heparin expose platelet count falls 50% below baseline
HIT or heparin induced thrombocytopenia
What is the normal range for Anti-factor or ANTI-XA?
0.3 to 0.7
Ranges for ACT?
180-220
Ranges for PTT?
60-80
Venous inlet pressures should be ___ than post membrane pressure
slightly greater.
Pre/Posts arterial pressure should not exceed what? What is there a risk for?
300-350, hemolysis
typical range of SVO2 on a premembrane blood gas
65-75%
PO2 on a post membrane gas should be?
300-500mmHg
Post membrane gas SAO2 should be?
98-100%
the volume of blood in patient is known as?
Preload
resitance in the patient that ecmo circuit has to overcome is known as?
Afterload
3 causes of decrease in preload?
- bleeding/diuresis/dialysis
-hypovolemia
-mechanical obstruction (tension pneumo, tamponade, abdominal compartment syndrome)
3 causes of increase in afterload
-increased systemic vascular resistance (hypertension)
-kinking in circuit tubing
-thrombus
3 reasons to decrease ecmo blood flow rate?
- patient shows recovery/ability to oxygenate on own
-hemolysis w/ high pressures/speed
-chatter and flow rates are fluctuating/irregular
2 reasons to increase ecmo blood flow rate
-signs of hypoxia/hypoxemia (decreased spo2 and/or pao2)
-signsof decreased perfusion (elevated lactate)
