Chest computed tomography angiography in children on extracorporeal membrane oxygenation (ECMO)

Hull, Nathan C.; Schooler, Gary R.; Binkovitz, Larry A.; Williamson, Eric E.; Araoz, Phillip A.; Yu, Lifeng; Young, Philip

doi:10.1007/s00247-017-4034-3

Cited by 8 publications

(4 citation statements)

References 14 publications

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“…Appropriate scanner operation is also important to ensure that patient safety is not jeopardized, especially for some special scanning modes. For example, CT is useful for evaluating serious issues in children who are receiving extracorporeal membrane oxygenation (ECMO), but extreme care must be taken during patient transportation and CT scanning to not disconnect the ECMO cannulas and other life-supporting lines, which could result in life-threatening accidents 65 . Fast helical scanning is helpful to reduce motion artifacts; however, it requires extra table excursion beyond the scan range.…”

Section: Ct Safety Considerationsmentioning

confidence: 99%

“…For example, CT is useful for evaluating serious issues in children who are receiving extracorporeal membrane oxygenation (ECMO), but extreme care must be taken during patient transportation and CT scanning to not disconnect the ECMO cannulas and other life-supporting lines, which could result in life-threatening accidents. 65 Fast helical scanning is helpful to reduce motion artifacts; however, it requires extra table excursion beyond the scan range. Close attention must be paid to prevent tension or disconnection of the ECMO CASE 2-2 A 37-year-old woman underwent imaging for headache, and her CT showed artifacts in the brain mimicking hypodense white matter that raised serious concerns of cerebral edema (FIGURE 2-7A).…”

Section: Issues Related To Ct Personnel and Operatorsmentioning

confidence: 99%

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Safety Considerations in MRI and CT

Watson¹,

Yu²

2023

CONTINUUM: Lifelong Learning in Neurology

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OBJECTIVE: MRI and CT are indispensable imaging modalities for the evaluation of patients with neurologic disease, and each is particularly well suited to address specific clinical questions. Although both of these imaging modalities have excellent safety profiles in clinical use as a result of concerted and dedicated efforts, each has potential physical and procedural risks that the practitioner should be aware of, which are described in this article.LATEST DEVELOPMENTS: Recent advancements have been made in understanding and reducing safety risks with MR and CT. The magnetic fields in MRI create risks for dangerous projectile accidents, radiofrequency burns, and deleterious interactions with implanted devices, and serious patient injuries and deaths have occurred. Ionizing radiation in CT may be associated with shorter-term deterministic effects on biological tissues at extremely high doses and longer-term stochastic effects related to mutagenesis and carcinogenesis at low doses. The cancer risk of radiation exposure in diagnostic CT is considered extremely low, and the benefit of an appropriately indicated CT examination far outweighs the potential risk. Continuing major efforts are centered on improving image quality and the diagnostic power of CT while concurrently keeping radiation doses as low as reasonably achievable.ESSENTIAL POINTS: An understanding of these MRI and CT safety issues that are central to contemporary radiology practice is essential for the safe and effective treatment of patients with neurologic disease.

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Section: Ct Safety Considerationsmentioning

confidence: 99%

Section: Issues Related To Ct Personnel and Operatorsmentioning

confidence: 99%

Safety Considerations in MRI and CT

Watson¹,

Yu²

2023

CONTINUUM: Lifelong Learning in Neurology

Self Cite

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“…Postoperative residual lesions of CHD can significantly increase the risk of postoperative complications and mortality rate [ 40 ]. Therefore, transesophageal echocardiography during the operation to detect residual lesions and timely intervention are conducive to the smooth withdrawal of CPB [ 41 – 43 ]. If there is no sign of myocardial function recovery after 48–72 hours of ECMO support, it is necessary to positively identify residual anatomical malformation.…”

Section: Residual Lesionsmentioning

confidence: 99%

“…Many factors, such as wound dressings, opened sternum, various cannulations and inappropriate size of ultrasound probe, can affect the acquisition of standard ultrasound views. If necessary, further examinations, such as cardiac catheterization or computed tomography angiography (CTA), can be recommended [ 43 – 45 ].…”

Section: Residual Lesionsmentioning

confidence: 99%

Perioperative extracorporeal membrane oxygenation in pediatric congenital heart disease: Chinese expert consensus

Lin

Wang

et al. 2022

World J Pediatr

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Background Congenital heart disease (CHD) is one of the main supportive diseases of extracorporeal membrane oxygenation in children. The management of extracorporeal membrane oxygenation (ECMO) for pediatric CHD faces more severe challenges due to the complex anatomical structure of the heart, special pathophysiology, perioperative complications and various concomitant malformations. The survival rate of ECMO for CHD was significantly lower than other classifications of diseases according to the Extracorporeal Life Support Organization database. This expert consensus aims to improve the survival rate and reduce the morbidity of this patient population by standardizing the clinical strategy. Methods The editing group of this consensus gathered 11 well-known experts in pediatric cardiac surgery and ECMO field in China to develop clinical recommendations formulated on the basis of existing evidences and expert opinions. Results The primary concern of ECMO management in the perioperative period of CHD are patient selection, cannulation strategy, pump flow/ventilator parameters/vasoactive drug dosage setting, anticoagulation management, residual lesion screening, fluid and wound management and weaning or transition strategy. Prevention and treatment of complications of bleeding, thromboembolism and brain injury are emphatically discussed here. Special conditions of ECMO management related to the cardiovascular anatomy, haemodynamics and the surgical procedures of common complex CHD should be considered. Conclusions The consensus could provide a reference for patient selection, management and risk identification of perioperative ECMO in children with CHD.

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Novel CT Acquisition

2019

Computed Tomography

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Chest computed tomography angiography in children on extracorporeal membrane oxygenation (ECMO)

Cited by 8 publications

References 14 publications

Safety Considerations in MRI and CT

Safety Considerations in MRI and CT

Perioperative extracorporeal membrane oxygenation in pediatric congenital heart disease: Chinese expert consensus

Novel CT Acquisition

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