A neonatal patient is receiving venovenous bypass ECLS and ...

[Brittanyd9008]

A neonatal patient is receiving venovenous bypass ECLS and suddenly develops cardiac insufficiency. What should the therapist recommend for this patient at this time?
 
  A. Increase the patient's fluid volume.
  B. Administer an antihypertensive medication.
  C. Provide inotropic drugs.
  D. Institute HFV with inhaled nitric oxide.

Question 2

During neonatal and pediatric 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 = inferior vena cava; arterial return = subclavian artery
  B. venous feed = right atrium; arterial return = left atrium
  C. venous feed = right atrium; arterial return = common carotid artery
  D. venous feed = internal jugular vein; arterial return = common carotid artery

[jennafosdick]

Answer to Question 1

ANS: C
A. Incorrect response: See explanation C.
B. Incorrect response: See explanation C.
C. Correct response: Venovenous bypass ECLS takes only a portion (i.e., 30 to 60) of the cardiac output from the venous circulation, passes it through a membrane oxygenator, and returns it to the major veins. Venovenous ECLS is essentially adding another lung to the patient and is generally reserved for patients with adequate cardiac output. If cardiac insufficiency develops, the patient must be supported by inotropic drugs or surgically converted to venoarterial ECLS.
D. Incorrect response: See explanation C.

Answer to Question 2

ANS: D
A. Incorrect response: See explanation D.
B. Incorrect response: See explanation D.
C. Incorrect response: See explanation D.
D. Correct response: Neonatal and pediatric venoarterial extracorporeal support generally accesses the right atrium for venous return via cannulation of the internal jugular vein. The common carotid artery is cannulated for arterial blood return to the body.