E1361. Imaging in ECMO
  1. Som Biswas; Le Bonheur Children's Hospital
  2. Preet Sandhu; Le Bonheur Children's Hospital
The use of extracorporeal membrane oxygenation (ECMO) as therapeutic support in infants with severe respiratory disease has increased exponentially over the last decade. Imaging plays a major role in the management of patients both before and during ECMO support. It is imperative that pediatric radiologists in ECMO units are vigilant in the reporting of apparatus positions and complications of treatment. The role of radiology in ECMO support is not well reported. Our educational exhibit discusses the normal radiologic appearances during ECMO. The range of bypass cannula positions is highlighted. The radiologic findings in the complications of ECMO are illustrated.

Educational Goals / Teaching Points
This exhibit aims to teach the radiologist and resident normal position of extracorporeal membrane oxygenation (ECMO) cannulas, abnormal position of extracorporeal membrane oxygenation (ECMO) cannulas, and imaging findings arising from the complications of ECMO.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Normal ECMO cannula position: Right jugular approach venous/drainage cannula with the tip in the right atrium and arterial/reinfusion cannula tip in the common carotid artery close to its origin from the aortic arch. Subdural hemorrhages, as a complication of ECMO, on brain CT images. Whiteout lung on a radiograph, commonly seen in ECMO patients. Hemo-thorax as a complication of ECMO, on CT images. MCA infarct, as a complication of ECMO, on Ultrasound, CT, and MRI images. Intracranial hemorrhage, as a complication of ECMO, on Ultrasound, and CT images.

Radiology has a very important role in the vigilant reporting of ECMO cannula positions and complications.