Extracorporeal membranous oxygenation (ECMO) in polytrauma: what the radiologist needs to know

Dreizin, David; Menaker, Jay; Scalea, Thomas M.

doi:10.1007/s10140-015-1324-7

Cited by 8 publications

(17 citation statements)

References 69 publications

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“…During ECMO, blood is drained from the patient's native vascular system, propagated by a mechanical pump device, and then re-introduced back into circulation [17,29]. There are two major types of ECMO: (a) VV-ECMO and (b) VA-ECMO [30].…”

Section: Ecmo: a Synopsismentioning

confidence: 99%

Extracorporeal Membrane Oxygenation in Traumatic Injury: An Overview of Utility and Indications

Hughes¹,

Cipolla²,

Thomas³

et al. 2016

Extracorporeal Membrane Oxygenation: Advances in Therapy

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Severe respiratory failure may develop in the trauma patient as a consequence of direct lung injury, in response to trauma-associated systemic inflammatory response syndrome SIRS , as a result of infection, or at times as an unintended consequence of the life-saving management of the acute traumatic injury. "pproximately . % of all adult trauma patients develop some form of pulmonary dysfunction along the acute lung injury "LI acute respiratory distress "RDS spectrum, with the incidence of severe respiratory failure reaching % in multisystem trauma victims. Of concern, mortality in patients with acute respiratory failure who go on to develop severe pulmonary dysfunction can be as high as % with the use of conventional therapeutic modalities. Extracorporeal membrane oxygenation ECMO has been proposed as a rescue strategy when less invasive primary or adjunctive attempts fail. Numerous case reports and single-center studies demonstrate potential benefits of early implementation of veno-venous VV -ECMO for the treatment of severe respiratory failure associated with trauma or sequelae of trauma. In this clinical context, VV-ECMO can be employed to correct for both ventilatory and oxygenation failure while allowing the treating physician to provide much needed rest to the patient's lungs and permit healing to take place. The use of ECMO mainly veno-venous, with limited use of veno-arterial circuits for cardiac indications has been described in patients with severe chest injuries, traumatic pneumonectomy, bronchopleural fistulas, and various forms of respiratory failure refractory to conventional therapies.

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Section: Ecmo: a Synopsismentioning

confidence: 99%

Extracorporeal Membrane Oxygenation in Traumatic Injury: An Overview of Utility and Indications

Hughes¹,

Cipolla²,

Thomas³

et al. 2016

Extracorporeal Membrane Oxygenation: Advances in Therapy

View full text Add to dashboard Cite

show abstract

“…: vv-ECMO) [12,13]. The blood that is removed venously and is oxygenated and decarboxylated extracorporeally is returned to the venous system or the right atrium.…”

Section: Extracorporeal Membrane Oxygenation (Ecmo)mentioning

confidence: 99%

“…1). Alternatively, it is possible to use a double lumen cannula (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31) that is positioned through the internal jugular vein and the right atrium with the tip in the inferior vena cava [6,12,13,16,17].…”

Section: Extracorporeal Membrane Oxygenation (Ecmo)mentioning

confidence: 99%

“…This is referred to as ECLS therapy [10,12,13]. The term veno-arterial ECMO therapy (va-ECMO) is often used as a synonym in the clinical routine as well as the literature.…”

Section: Extracorporeal Life Support (Ecls)mentioning

confidence: 99%

“…If the tips of the two cannulas are too close together in venovenous ECMO, the blood primarily flows through the extracorporeal circuit from one cannula to the next so that the pulmonary circulation and thus also the systemic circulation primarily receive insufficiently oxygenated blood due to the recirculation [5,13,16,17] (▶ Fig. 4).…”

Section: Cannula Positionmentioning

confidence: 99%

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Extrakorporale Membranoxygenierung bei Erwachsenen – Varianten, Komplikationen unter Therapie und die Rolle der radiologischen Diagnostik

Beck¹,

Burg²,

Heindel³

et al. 2016

Fortschr Röntgenstr

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ABSTR ACTBackground Extracorporeal membrane oxygenation (ECMO) and extracorporeal life support (ECLS) as respiratory and circulatory assist therapies are gaining in importance in the treatment of critically ill patients. Depending on the place of cannulation -veno-venous for ECMO and veno-arterial for ECLS -distinct changes in hemodynamics will occur. In this review we describe the different types of ECMO and ECLS systems, the typical cannula placement and frequent complications under therapy. The most suitable imaging modalities will be presented and typical hemodynamic pitfalls in contrast-enhanced computed tomography or angiography will be elucidated. MethodsThe review is based on a literature search in PubMed with the terms "ECMO" and/or "ECLS" and/or "extracorporeal life support" and/or "imaging" and/or "complications". Statistical data was taken from the ECMO register of the "Extracorporeal Life Support Organization (ELSO)".Results Critical illness-and therapy-associated complications are common so that imaging, particularly computed tomography, becomes increasingly important. Following veno-venous cannulation in ECMO, the normal sequential blood flow is preserved, so that no contrast enhancement irregularities should be expected when the right timing and an adequate amount of contrast agent are selected. After veno-arterial cannulation in ECLS, different artifacts like pseudo-filling defects, pseudomembranes and irregular/low contrast enhancement of heart and pulmonary vessels can be found, depending on the site of cannulation and the residual cardiac function.Key points ▪ Cannula placement is usually documented by radiography. This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.

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ECMO Safety in the Setting of Traumatic Brain Injury

Parker

Menaker

Stein

2021

Difficult Decisions in Trauma Surgery

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Extracorporeal membranous oxygenation (ECMO) in polytrauma: what the radiologist needs to know

Cited by 8 publications

References 69 publications

Extracorporeal Membrane Oxygenation in Traumatic Injury: An Overview of Utility and Indications

Extracorporeal Membrane Oxygenation in Traumatic Injury: An Overview of Utility and Indications

Extrakorporale Membranoxygenierung bei Erwachsenen – Varianten, Komplikationen unter Therapie und die Rolle der radiologischen Diagnostik

ECMO Safety in the Setting of Traumatic Brain Injury

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