Extracorporeal Membrane Oxygenation (ECMO) Specialist Practice Exam

One of the complications that can occur in a patient on ECMO is left ventricular (LV) distension. This situation arises primarily when the ECMO device is not providing sufficient support or when there is an inadequate drainage of blood from the heart. In ECMO setups, especially veno-arterial (VA) ECMO, the venous return to the circuit can affect the preload of the heart, and if the heart is not effectively pumping, significant blood can accumulate in the left ventricle.

This distension can lead to elevated pressures within the heart and pulmonary circulation, potentially resulting in poor cardiac output and pulmonary edema. Managing LV distension involves careful monitoring and potentially modifying the ECMO support parameters, including adjusting flows or using additional interventions like diuretics or inotropes to prevent further complications. Understanding this risk is crucial for optimizing patient outcomes in those receiving ECMO therapy.

The other options, while they can be complications associated with ECMO, do not directly align with the significant and immediate concerns related to the heart's performance in relation to the ECMO system itself as LV distension does. For example, infection is a concern with any invasive procedure but is more generalized, hypertension can happen but may not directly relate to the