Marika K Lidegran1, Hans G Ringertz, Björn P Frenckner, Viveka B Lindén. 1. Department of Pediatric Radiology, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Karolinska Institute SE-171 76, Stockholm, Sweden. marika.lidegran@karolinska.se
Abstract
RATIONALE AND OBJECTIVE: This study aims to evaluate the clinical usefulness of thoracic and abdominal computed tomography (CT) as an adjunct to bedside diagnostic imaging in patients on extracorporeal membrane oxygenation (ECMO) therapy because of severe acute respiratory failure. MATERIALS AND METHODS: Imaging records for 118 consecutive thoracic and abdominal CT examinations performed in 63 patients (22 neonates, 15 children, and 26 adults) on ECMO therapy during an 8-year period were retrospectively reviewed. Reported CT findings were compared with concurrent bedside radiographs and ultrasounds. The clinical importance and effect on treatment of each CT finding was determined by reviewing the medical records. RESULTS: CT showed 30 clinically important complications in 20 different patients that directly impacted on the treatment, but were not diagnosed with bedside imaging. Of the 30 complications, 15 (50%) were surgically treated, 11 (37%) required percutaneous invasive procedures, and 4 (13%) were managed conservatively. Despite the serious complications, 13 of 20 patients (65%) survived. CONCLUSION: Both chest and abdominal CT have an important clinical role in patients on ECMO therapy because of acute respiratory failure, as a complement to bedside imaging, to exclude or show complications and expedite early invasive treatment, when needed.
RATIONALE AND OBJECTIVE: This study aims to evaluate the clinical usefulness of thoracic and abdominal computed tomography (CT) as an adjunct to bedside diagnostic imaging in patients on extracorporeal membrane oxygenation (ECMO) therapy because of severe acute respiratory failure. MATERIALS AND METHODS: Imaging records for 118 consecutive thoracic and abdominal CT examinations performed in 63 patients (22 neonates, 15 children, and 26 adults) on ECMO therapy during an 8-year period were retrospectively reviewed. Reported CT findings were compared with concurrent bedside radiographs and ultrasounds. The clinical importance and effect on treatment of each CT finding was determined by reviewing the medical records. RESULTS: CT showed 30 clinically important complications in 20 different patients that directly impacted on the treatment, but were not diagnosed with bedside imaging. Of the 30 complications, 15 (50%) were surgically treated, 11 (37%) required percutaneous invasive procedures, and 4 (13%) were managed conservatively. Despite the serious complications, 13 of 20 patients (65%) survived. CONCLUSION: Both chest and abdominal CT have an important clinical role in patients on ECMO therapy because of acute respiratory failure, as a complement to bedside imaging, to exclude or show complications and expedite early invasive treatment, when needed.
Authors: Karen I Ramirez-Suarez; Luis Octavio Tierradentro-García; Hansel J Otero; Jordan B Rapp; Ammie M White; Sara L Partington; Matthew A Harris; Seth A Vatsky; Kevin K Whitehead; Mark A Fogel; David M Biko Journal: Pediatr Radiol Date: 2021-10-17
Authors: Nathan C Hull; Gary R Schooler; Larry A Binkovitz; Eric E Williamson; Phillip A Araoz; Lifeng Yu; Philip M Young Journal: Pediatr Radiol Date: 2017-12-07
Authors: Pradnya D Patil; Samir Sultan; M Frances Hahn; Sreeja Biswas Roy; Mitchell D Ross; Hesham Abdelrazek; Ross M Bremner; Nitika Thawani; Rajat Walia; Tanmay S Panchabhai Journal: Respir Med Case Rep Date: 2018-06-12
Authors: Anton Faron; Stefan Kreyer; Alois M Sprinkart; Thomas Muders; Stefan F Ehrentraut; Alexander Isaak; Rolf Fimmers; Claus C Pieper; Daniel Kuetting; Jens-Christian Schewe; Ulrike Attenberger; Christian Putensen; Julian A Luetkens Journal: Sci Rep Date: 2020-12-28 Impact factor: 4.379