Author Question: During adult venoarterial bypass ECLS, which vessels or heart chambers are commonly cannulated to ... (Read 62 times)

dejastew · **on:** Jul 16, 2018

During adult venoarterial bypass ECLS, which vessels or heart chambers are commonly cannulated to feed venous blood from the patient's body to the pump, and to return arterial blood to the patient?

A. venous feed = right atrium; arterial return = aortic arch
B. venous feed = inferior vena cava; arterial return = subclavian artery
C. venous feed = internal jugular vein; arterial return = aortic arch
D. venous feed = right atrium; arterial return = subclavian artery

Question 2

Which of the following complications of ECLS is the most common?

A. anticoagulation
B. hypotensive injury to organs
C. hemorrhage
D. clot formation

Harbringer · **Reply #1 on:** Jul 16, 2018

Answer to Question 1

ANS: A
A. Correct response: Adult patients undergoing venoarterial extracorporeal support typically require alteration of the neonatal-pediatric procedure. Adults commonly undergo transthoracic access to the right atrium and aortic arch, or the femoral artery. Venoarterial ECLS is almost complete cardiopulmonary bypass, draining venous return from the right atrium, circulating the blood through extracorporeal circuit, and then returning the blood to the body via the aortic arch.
B. Incorrect response: See explanation A.
C. Incorrect response: See explanation A.
D. Incorrect response: See explanation A.

Answer to Question 2

ANS: C
A. Incorrect response: See explanation C.
B. Incorrect response: See explanation C.
C. Correct response: Complications of ECLS usually are related to anticoagulation, pre-existing hypoxic or hypotensive injury to organs, and technical and mechanical complications within the ECLS circuit. Hemorrhage is the most common and most disastrous complication of ECLS, and occurs in approximately 25 of neonatal cases. Bleeding most commonly occurs in the central nervous system, the gastrointestinal tract, and the lungs, or at operative sites. The most devastating of these occurs in the brain.
D. Incorrect response: See explanation C.