title: Hemodynamic changes in patients with extracorporeal membrane oxygenation (ECMO) demonstrated by contrast-enhanced CT examinations - implications for image acquisition technique.
abstract: Extracorporeal membrane oxygenation (ECMO) is an established tool for respiratory and circulatory support. In computed tomography, altered hemodynamics in ECMO patients requires special considerations and handling in contrast injection and its timing. In this article, we demonstrate changes in hemodynamics in ECMO patients captured on contrast-enhanced CT examinations and pitfalls in strategies for contrast injection in relation to the ECMO flow, cardiac function and the placement of ECMO cannulas. Contrast-enhanced CT of patients with ECMO requires prior knowledge of the ECMO cannulas, central venous lines, changes of hemodynamics induced by low cardiac output and the influence of adjustment of ECMO on blood flow in order to optimize injection of the contrast material and timing of the scan. Special considerations include temporary reduction of the ECMO flow, selection of the injection site and increasing volume or flow rate of the contrast material.
authors: 1 Department of Radiology, General University Hospital in Prague, First Faculty of Medicine, Charles University in Prague, Czech Republic.
authors: Lukas
authors: L
authors: Lambert
authors: 2 2nd Department of Surgery, Cardiovascular Surgery, General University Hospital in Prague, First Faculty of Medicine, Charles University in Prague, Czech Republic.
authors: Tomas
authors: T
authors: Grus
authors: 3 Department of Anesthesiology, Resuscitation and Intensive Care, General University Hospital in Prague, First Faculty of Medicine, Charles University in Prague, Czech Republic.
authors: Martin
authors: M
authors: Balik
authors: 2 2nd Department of Surgery, Cardiovascular Surgery, General University Hospital in Prague, First Faculty of Medicine, Charles University in Prague, Czech Republic.
authors: Jaromir
authors: J
authors: Fichtl
authors: 1 Department of Radiology, General University Hospital in Prague, First Faculty of Medicine, Charles University in Prague, Czech Republic.
authors: Jan
authors: J
authors: Kavan
authors: 4 2nd Department of Medicine, Cardiovascular Medicine, General University Hospital in Prague, First Faculty of Medicine, Charles University in Prague, Czech Republic.
authors: Jan
authors: J
authors: Belohlavek
mesh_terms: D000328:Adult; D003287:Contrast Media / Q000008:administration & dosage* / Q000032:analysis; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media
keywords: central venous line; computed tomography; contrast material; extracorporeal membrane oxygenation; hemodynamics