Skip to main content
Log in

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

  • Pictorial Essay
  • Published:
Pediatric Radiology Aims and scope Submit manuscript

A Correction to this article was published on 03 January 2018

This article has been updated

Abstract

Performing chest CT angiography on pediatric patients on extracorporeal membrane oxygenation (ECMO) can be challenging. Successfully performing CT angiography in these children requires substantial communication and coordination between the radiologists and clinical care providers. Additionally, the radiologist must understand the child’s anatomy and disease pathophysiology, flow dynamics of the ECMO circuit, image acquisition timing, contrast injection site, and volume, rate and duration of contrast administration. In this article we highlight the vital factors the radiologist needs to consider to optimize the chest CT angiography in pediatric patients on ECMO.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

Change history

  • 03 January 2018

    The published version of this article incorrectly lists the authors’ affiliations. The correct affiliations are given below. The Publisher regrets this mistake.

References

  1. Weinhaus L, Canter C, Noetzel M et al (1989) Extracorporeal membrane oxygenation for circulatory support after repair of congenital heart defects. Ann Thorac Surg 48:206–212

    Article  PubMed  CAS  Google Scholar 

  2. Raithel SC, Pennington DG, Boegner E et al (1992) Extracorporeal membrane oxygenation in children after cardiac surgery. Circulation 86:II305–II310

    PubMed  CAS  Google Scholar 

  3. Goodwin SJ, Randle E, Iguchi A et al (2014) Chest computed tomography in children undergoing extra-corporeal membrane oxygenation: a 9-year single-centre experience. Pediatr Radiol 44:750

    Article  PubMed  Google Scholar 

  4. Maslach-Hubbard A, Bratton SL (2013) Extracorporeal membrane oxygenation for pediatric respiratory failure: history, development and current status. World J Crit Care Med 2:29–39

    Article  PubMed  PubMed Central  Google Scholar 

  5. Extracorporeal Life Support Organization (ELSO) (2017) ECLS registry report: international summary. http://www.elso.org/Registry/Statistics/InternationalSummary.aspx. Accessed 5 Aug 2017

  6. Lidegran MK, Ringertz HG, Frenckner BP, Lindén VB (2005) Chest and abdominal CT during extracorporeal membrane oxygenation: clinical benefits in diagnosis and treatment. Acad Radiol 12:276–285

    Article  PubMed  Google Scholar 

  7. Nair AB, Oishi P (2016) Venovenous extracorporeal life support in single-ventricle patients with acute respiratory distress syndrome. Front Pediatr 4:66

    Article  PubMed  PubMed Central  Google Scholar 

  8. Extracorporeal Life Support Organization (ELSO) (2013) Guidelines for pediatric cardiac failure. Version 1.3. https://www.elso.org/Portals/0/IGD/Archive/FileManager/518a079853cusersshyerdocumentselsoguidelinesforpediatriccardiacfailure1.3.pdf. Accessed 27 April 2017

  9. Chaturvedi RR, Macrae D, Brown KL et al (2004) Cardiac ECMO for biventricular hearts after paediatric open heart surgery. Heart 90:545–551

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  10. Rigsby CK, Gasber E, Seshadri R et al (2007) Safety and efficacy of pressure-limited power injection of iodinated contrast medium through central lines in children. AJR Am J Roentgenol 188:726–732

    Article  PubMed  Google Scholar 

  11. Schooler GR, Zurakowski D, Lee EY (2015) Evaluation of contrast injection site effectiveness: thoracic CT angiography in children with hand injection of IV contrast material. AJR Am J Roentgenol 204:423–427

    Article  PubMed  Google Scholar 

  12. Hellinger JC, Pena A, Poon M et al (2010) Pediatric computed tomography angiography: imaging the cardiovascular system gently. Radiol Clin N Am 48:439–467

    Article  PubMed  Google Scholar 

  13. Lee CH, Goo JM, Bae KT et al (2007) CTA contrast enhancement of the aorta and pulmonary artery: the effect of saline chase injected at two different rates in a canine experimental model. Investig Radiol 42:487–490

    Google Scholar 

  14. Lee S, Chaturvedi A (2014) Imaging adults on extracorporeal membrane oxygenation (ECMO). Insights Imaging 5:731–742

    Article  PubMed  PubMed Central  Google Scholar 

  15. Hartmann IJC, Lo RTH, Bakker J et al (2002) Optimal scan delay in spiral CT for the diagnosis of acute pulmonary embolism. J Comput Assist Tomogr 26:21–25

    Article  PubMed  Google Scholar 

  16. Frush DP, Soden B, Frush KS et al (2002) Improved pediatric multidetector body CT using a size-based color-coded format. AJR Am J Roentgenol 178:721–726

    Article  PubMed  Google Scholar 

  17. Nievelstein RAJ, van Dam IM, van der Molen AJ (2010) Multidetector CT in children: current concepts and dose reduction strategies. Pediatr Radiol 40:1324–1344

    Article  PubMed  PubMed Central  Google Scholar 

  18. Image Gently (2014) Image Gently development of pediatric CT protocols 2014. http://www.imagegently.org/Portals/6/Procedures/IG%20CT%20Protocols%20111714.pdf. Accessed 27 April 2017

Download references

Acknowledgements

The authors would like to give special thanks to clinical perfusionist Tiffany Robb for her contribution to this article.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Nathan C. Hull.

Ethics declarations

Conflicts of interest

None

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hull, N.C., Schooler, G.R., Binkovitz, L.A. et al. Chest computed tomography angiography in children on extracorporeal membrane oxygenation (ECMO). Pediatr Radiol 48, 1021–1030 (2018). https://doi.org/10.1007/s00247-017-4034-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00247-017-4034-3

Keywords

Navigation