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ECMO Study Guide > Lab Values and Drugs > Flashcards

Lab Values and Drugs Flashcards

1
Q

For each of the values listed below what is normal and where do we like this
value to be while pt on ECMO. Explain.
PH

A

7.35-7.45

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2
Q

For each of the values listed below what is normal and where do we like this
value to be while pt on ECMO. Explain.
a. PH

A

35-45

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3
Q

PO2

A

On ECMO - >200

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4
Q

Lactate

A

0.5 - 2

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5
Q

NaHCO3

A

22-28

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6
Q

Base deficit

A

+/- 4

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7
Q

Hgb/HCT

A

12-15 (women) & 13-17 (men)
On ECMO (Adult > 7, Peds > 10)

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8
Q

Sodium

A

135-145

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9
Q

Potassium

A

3.6-5.1

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10
Q

Serum calcium

A

8.9-10.7

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11
Q

Ionized Calcium

A

1.16-1.32

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12
Q

Ionized Magnesium

A

0.46 - 0.64

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13
Q

PT

A

12.3-14.8 s

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14
Q

PTT

A

25-36
On ECMO - 60-80 seconds

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15
Q

Anti Xa (AKA Unfractionated Heparin)

A

On ECMO - 0.3 - 0.7
If bleeding 0.2-0.5

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16
Q

Cultures

A

You want negative cultures! Blood, urine, respiratory.

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16
Q

ATIII activity (< 30 days, > 30 days)

A

< 30 days (44-76 %)
> 30 days (80-120 %)
ATIII binds with heparin to work as an anticoagulant, heparin does
not work by itself.

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17
Q

Plasma Hgb

A

< 12

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18
Q

Fibrinogen

A

200-400

19
Q

INR

A

<2 (On ECMO < 4.9)

20
Q

Troponin

A

0-0.4

21
Q

CK

A

40-350

22
Q

CK mb

A

0-5

23
Q

ALT

A

0-40

24
Q

AST

A

0-95

25
Q

Describe the relationship of these tests to ECMO.
a. Head ultrasound
- Is this done on all ECMO patients

A

Neonates and Infants

26
Q

-When is this test done?

A

Done pre-cannulation and then once a day for the first 3
days, then every other day.

27
Q

-What does this result show?

A

Intracranial hemorrhage, blood in the ventricles

28
Q

Why is this important to patients on ECMO?

A

It’s a contraindication for ECMO. If it’s a grade 1-2 then they
will keep an eye on it, if its a grade 3 or larger either will DC ECMO or
not put patient on ECMO

29
Q

b. Chest x-ray
-Is this done on all ECMO patients

A

Yes

30
Q

When is this test done?

A

After cannulation and daily/PRN

31
Q

What does this test tell us?

A

Cannula Placement

32
Q

Discuss the importance of this test.

A

Misplaced cannulas can cause decreased flows, chugging,
recirculation (VV), high negative pressures, high positive pressures.

33
Q

c. Cardiac ECHO
-When is this test done?

A

Adults - during weaning (PRN to confirm cannula placement)
Neonates - Pre-ECMO and (PRN to confirm cannula
placement)

34
Q

Is this done on all ECMO patients?

A

Yes

35
Q

What do we learn from this test?

A

Cardiac function, pulmonary artery pressures.

36
Q

Are the results usually normal or abnormal?

A

Usually abnormal for VA and normal for VV

37
Q

d. CT Scan
-When is it done?

A

Change in patient status

38
Q

What do we learn from this test

A

Check for head bleed, abdominal function (with contrast)

39
Q

How does this affect the care of our patient?

A

Can give immediate answers. Sometimes is not tolerated
well by patient. If results are poor, then a conversation may happen
to discontinue ECMO.

40
Q

Do all patients have this test?

A

No, would only need done for a specific change in patient
status.

41
Q

e. Fluoroscopy
-When is this used?

A

To place a double-lumen cannula safely.

42
Q

What does this tell the practitioner?

A

Cannula Placement

43
Q

What patients are most likely to have this done?

A

VV ECMO

44
Q

f. Cardiac Cath
i. When is this done?

A

If patient has had a STEMI, any patient on ECPR, create
balloon septostomy in neonates.

45
Q

Can patients on ECMO go to the Cath Lab?

A

Yes

46
Q

Describe the information that might come from this tes

A

Check for coronary blockage.

ECMO Study Guide (5 decks)

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