Contrast-Enhanced Echocardiography Application in Patients Supported by Extracorporeal Membrane Oxygenation (ECMO): A Narrative Review

Lashin, Hazem; Shepherd, Stephen J.; Smith, Andrew

doi:10.1053/j.jvca.2021.04.031

Cited by 13 publications

(7 citation statements)

References 57 publications

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“…In a series of 281 patients on PVA-ECMO, 11 (3.9%) developed left ventricular thrombus despite adequate anticoagulation, none of whom survived. 8 The diagnosis was based on TTE and confirmed with computed tomography in that series. However, that approach is only sometimes feasible, and mobilizing these patients is impossible due to their critical status.…”

Section: Discussionmentioning

confidence: 71%

“…7 Although UEA microspheres could trigger ECMO circuit sensor alarms and cause a sudden assistance halt, this is an anecdotal event. 8 In none of the cases presented herein did ECMO sensors trigger loss of assistance. Nevertheless, we recommend reviewing the ECMO machine manufacturer's specifications relative to the use of a UEA and always working in coordination with staff who have had specific training in ECMO troubleshooting.…”

Section: Discussionmentioning

confidence: 76%

“…Identifying left ventricular thrombus is of paramount importance. In a series of 281 patients on PVA‐ECMO, 11 (3.9%) developed left ventricular thrombus despite adequate anticoagulation, none of whom survived 8 . The diagnosis was based on TTE and confirmed with computed tomography in that series.…”

Section: Discussionmentioning

confidence: 86%

See 2 more Smart Citations

A contrast echocardiography‐based protocol to rule out thrombus in Venous‐Arterial ECMO: A proof of concept

et al. 2023

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 76%

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A contrast echocardiography‐based protocol to rule out thrombus in Venous‐Arterial ECMO: A proof of concept

et al. 2023

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“…2. respiratory support strategies: In addition to establishing a diagnosis of acute dyspnea, LUS could also assist in respiratory support strategies ( 35 ). LUS has the advantages of predicting response to recruitment ( 36 ), prone positioning ( 37 , 38 ), assessment of extravascular lung water and fluid management ( 39 , 40 ), and even extracorporeal membrane oxygenation (ECMO) support ( 41 ). Combined with CCE, RV function is also important to be evaluated in the ventilation strategy and management in ARDS.…”

Section: Methodsmentioning

confidence: 99%

Visual Rounds Based on Multiorgan Point-of-Care Ultrasound in the ICU

et al. 2022

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Point-of-care ultrasonography (POCUS) is performed by a treating clinician at the patient's bedside, provides a acquisition, interpretation, and immediate clinical integration based on ultrasonographic imaging. The use of POCUS is not limited to one specialty, protocol, or organ system. POCUS provides the treating clinician with real-time diagnostic and monitoring information. Visual rounds based on multiorgan POCUS act as an initiative to improve clinical practice in the Intensive Care Unit and are urgently needed as part of routine clinical practice.

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“… Data collected by experts only were: a semi quantitative (≥ 40% or < 40%) visual LVEF assessment obtained from an apical 2 and 4 chamber view. Several studies performed both in cardiology or ICU patients have demonstrated that eyeballing (visual) semi quantitative LVEF (normal, moderate or severe impairment) assessment is valuable, especially in acute conditions[ 18 – 21 ]. mitral E wave velocity (m.s-1) and mitral A wave velocity (m.s -1 ) obtained from an apical 4 chamber view.…”

Section: Introductionmentioning

confidence: 99%

Echocardiographic hemodynamic assessment in decompensated cirrhosis: comparison between Intensivists and Gastroenterologists

Prost

Bourgaux

Louart

et al. 2023

J Clin Monit Comput

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Background & aims: Ascites is a frequent complication of cirrhosis. In intensive care units, initial hemodynamic assessment is frequently performed by echocardiography. This study evaluated the feasibility and usefulness of early hemodynamic assessment in the gastroenterology ward. Methods: This observational cohort study prospectively included all patients admitted to a teaching hospital’s gastroenterology unit for decompensated cirrhosis. A gastroenterologist with minimal training and an intensivist both performed an echocardiography exam. The primary outcome was inter-rater agreement and reliability for three echocardiography parameters: visual LVEF (Left Ventricular Ejection Fraction), subaortic VTI (velocity time integral) and E wave velocity. Secondary outcomes were agreement for presence of pleural effusion, description of 3 hemodynamics profiles (hypovolemic, hyperkinetic and intermediate), and 28-day mortality.Results: From March 2018 to March 2020, 53 patients were included. The median age was 62 years and 81% were men. Patients presented mostly advanced liver disease, with 43% Child-Pugh C and median MELD score of 15.2. The limits of agreement between intensivists and gastroenterologists for subaortic VTI were − 6.6 to 7.2 cm, and ranged from − 0.6 to 0.37 m.s -1 for E wave velocity. Clinically significant differences between intensivists and gastroenterologists were found in 22% for subaortic VTI and 24.5% for E wave velocity. Reliability was good for subaortic VTI (ICC: 0.79, 95% CI [0.58; 0.9;]) and moderate for E wave velocity (0.53, 95% CI [0.19; 0.74]). The three hemodynamics profiles had different prognosis, with a 28-day mortality for Hypovolemic, Intermediate and Hyperkinetic group of 31, 18, and 4%, respectively.Conclusion: Reliability of hemodynamic assessment by gastroenterologists was good, while agreement was unsatisfactory, advocating for further training. Transthoracic echocardiography can differentiate hypovolemia from hyperkinetic states. The role of transthoracic echocardiography in managing decompensated cirrhosis requires further study. Clinical trial number: NCT03650660.

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Contrast-Enhanced Echocardiography Application in Patients Supported by Extracorporeal Membrane Oxygenation (ECMO): A Narrative Review

Cited by 13 publications

References 57 publications

A contrast echocardiography‐based protocol to rule out thrombus in Venous‐Arterial ECMO: A proof of concept

A contrast echocardiography‐based protocol to rule out thrombus in Venous‐Arterial ECMO: A proof of concept

Visual Rounds Based on Multiorgan Point-of-Care Ultrasound in the ICU

Echocardiographic hemodynamic assessment in decompensated cirrhosis: comparison between Intensivists and Gastroenterologists

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