The Role of Echocardiography in Neonates and Pediatric Patients on Extracorporeal Membrane Oxygenation

Overview

Journal Front Pediatr

Specialty Pediatrics

Date 2018 Nov 13

PMID 30416991

Citations 6

Authors

Carles Bautista-Rodriguez

Joan Sanchez-de-Toledo

Eduardo M da Cruz

Affiliations

Soon will be listed here.

Abstract

Indications for extracorporeal membrane oxygenation (ECMO) and extracorporeal cardiopulmonary resuscitation (ECPR) are expanding, and echocardiography is a tool of utmost importance to assess safety, effectiveness and readiness for circuit initiation and separation. Echocardiography is key to anticipating complications and improving outcomes. Understanding the patient's as well as the ECMO circuit's anatomy and physiology is crucial prior to any ECMO echocardiographic evaluation. It is also vital to acknowledge that the utility of echocardiography in ECMO patients is not limited to the evaluation of cardiac function, and that clinical decisions should not be made exclusively upon echocardiographic findings. Though echocardiography has specific indications and applications, it also has limitations, characterized as: prior to and during cannulation, throughout the ECMO run, upon separation and after separation from the circuit. The use of specific and consistent echocardiographic protocols for patients on ECMO is recommended.

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References

Okumura K, Humpl T, Dragulescu A, Mertens L, Friedberg M . Longitudinal assessment of right ventricular myocardial strain in relation to transplant-free survival in children with idiopathic pulmonary hypertension. J Am Soc Echocardiogr. 2014; 27(12):1344-51. DOI: 10.1016/j.echo.2014.09.002. View

Berdajs D . Bicaval dual-lumen cannula for venovenous extracorporeal membrane oxygenation: Avalon© cannula in childhood disease. Perfusion. 2014; 30(3):182-6. DOI: 10.1177/0267659114544714. View

Phoon C, Divekar A, Rutkowski M . Pediatric echocardiography: applications and limitations. Curr Probl Pediatr. 1999; 29(6):157-85. DOI: 10.1016/s0045-9380(99)80034-6. View

Lubnow M, Philipp A, Foltan M, Enger T, Lunz D, Bein T . Technical complications during veno-venous extracorporeal membrane oxygenation and their relevance predicting a system-exchange--retrospective analysis of 265 cases. PLoS One. 2014; 9(12):e112316. PMC: 4251903. DOI: 10.1371/journal.pone.0112316. View

Wolf M, Kanter K, Kirshbom P, Kogon B, Wagoner S . Extracorporeal cardiopulmonary resuscitation for pediatric cardiac patients. Ann Thorac Surg. 2012; 94(3):874-9. DOI: 10.1016/j.athoracsur.2012.04.040. View

Kakino T, Saku K, Sakamoto T, Sakamoto K, Akashi T, Ikeda M . Prediction of hemodynamics under left ventricular assist device. Am J Physiol Heart Circ Physiol. 2016; 312(1):H80-H88. DOI: 10.1152/ajpheart.00617.2016. View

Levy P, Patel M, Groh G, Choudhry S, Murphy J, Holland M . Pulmonary Artery Acceleration Time Provides a Reliable Estimate of Invasive Pulmonary Hemodynamics in Children. J Am Soc Echocardiogr. 2016; 29(11):1056-1065. PMC: 5408579. DOI: 10.1016/j.echo.2016.08.013. View

Eastaugh L, Thiagarajan R, Darst J, McElhinney D, Lock J, Marshall A . Percutaneous left atrial decompression in patients supported with extracorporeal membrane oxygenation for cardiac disease. Pediatr Crit Care Med. 2014; 16(1):59-65. DOI: 10.1097/PCC.0000000000000276. View

Conrad S, Grier L, Scott L, Green R, Jordan M . Percutaneous cannulation for extracorporeal membrane oxygenation by intensivists: a retrospective single-institution case series. Crit Care Med. 2015; 43(5):1010-5. DOI: 10.1097/CCM.0000000000000883. View

10.

Scherer M, Sirat A, Moritz A, Martens S . Extracorporeal membrane oxygenation as perioperative right ventricular support in patients with biventricular failure undergoing left ventricular assist device implantation. Eur J Cardiothorac Surg. 2010; 39(6):939-44. DOI: 10.1016/j.ejcts.2010.09.044. View

11.

Hirose H, Yamane K, Marhefka G, Cavarocchi N . Right ventricular rupture and tamponade caused by malposition of the Avalon cannula for venovenous extracorporeal membrane oxygenation. J Cardiothorac Surg. 2012; 7:36. PMC: 3372439. DOI: 10.1186/1749-8090-7-36. View

12.

Chimot L, Marque S, Gros A, Gacouin A, Lavoue S, Camus C . Avalon© bicaval dual-lumen cannula for venovenous extracorporeal membrane oxygenation: survey of cannula use in France. ASAIO J. 2013; 59(2):157-61. DOI: 10.1097/MAT.0b013e31827db6f3. View

13.

Anavekar N, Gerson D, Skali H, Kwong R, Yucel E, Solomon S . Two-dimensional assessment of right ventricular function: an echocardiographic-MRI correlative study. Echocardiography. 2007; 24(5):452-6. DOI: 10.1111/j.1540-8175.2007.00424.x. View

14.

Burkett D, Slorach C, Patel S, Redington A, Ivy D, Mertens L . Impact of Pulmonary Hemodynamics and Ventricular Interdependence on Left Ventricular Diastolic Function in Children With Pulmonary Hypertension. Circ Cardiovasc Imaging. 2016; 9(9). PMC: 5012318. DOI: 10.1161/CIRCIMAGING.116.004612. View

15.

Unai S, Nguyen M, Tanaka D, Gorbachuk N, Marhefka G, Hirose H . Clinical Significance of Spontaneous Echo Contrast on Extracorporeal Membrane Oxygenation. Ann Thorac Surg. 2016; 103(3):773-778. DOI: 10.1016/j.athoracsur.2016.07.019. View

16.

Schmidt M, Burrell A, Roberts L, Bailey M, Sheldrake J, Rycus P . Predicting survival after ECMO for refractory cardiogenic shock: the survival after veno-arterial-ECMO (SAVE)-score. Eur Heart J. 2015; 36(33):2246-56. DOI: 10.1093/eurheartj/ehv194. View

17.

Arya B, Kerstein D, Leu C, Hayes D, Zuckerman W, Krishnan U . Echocardiographic Assessment of Right Atrial Pressure in a Pediatric and Young Adult Population. Pediatr Cardiol. 2015; 37(3):558-67. DOI: 10.1007/s00246-015-1315-1. View

18.

Kon Z, Pasrija C, Shah A, Griffith B, Garcia J . Venovenous Extracorporeal Membrane Oxygenation With Atrial Septostomy as a Bridge to Lung Transplantation. Ann Thorac Surg. 2016; 101(3):1166-9. DOI: 10.1016/j.athoracsur.2015.03.127. View

19.

Naeije R . Physiology of the pulmonary circulation and the right heart. Curr Hypertens Rep. 2013; 15(6):623-31. DOI: 10.1007/s11906-013-0396-6. View

20.

Czerwonko M, Fraga M, Goldberg D, Hedrick H, Laje P . Cardiovascular perforation during placement of an Avalon Elite® Bicaval dual lumen ECMO cannula in a newborn. J Card Surg. 2014; 30(4):370-2. DOI: 10.1111/jocs.12507. View