Echocardiography for extracorporeal membrane oxygenation.

Echocardiography for extracorporeal membrane oxygenation.
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DOI:
10.1111/echo.15266
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发表时间:
2022-03
影响因子:
1.5
通讯作者:
Addis, Dylan R.
Addis, Dylan R.
中科院分区:
医学4区
文献类型:
--
作者:
Hussey, Patrick T.;von Mering, Gregory;Nanda, Navin C.;Ahmed, Mustafa I.;Addis, Dylan R.

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体外膜肺氧合(ECMO)为心脏和/或呼吸衰竭患者提供先进的心肺生命支持。超声心动图可在ECMO启动前提供基本的诊断和解剖信息,允许安全有效的ECMO插管定位,指导流量优化,提供快速故障排除和患者评估的模式,并有助于最终撤机ECMO支持的决策。目前,在这种临床背景下,缺乏超声心动图评估的指南。在这篇综述中,我们提供了一个概述超声心动图的考虑,先进的成像参与这些复杂的病人的护理。我们主要关注新的插管和复杂的插管技术,包括特别关注双腔插管和讨论间接左心室通气的章节。超声心动图在这些具有挑战性的临床情况下提供最佳护理方面具有极大的价值。这是必要的成像医师了解相关的解剖考虑,往往复杂的生理和血流动力学的背景下,和成像方式的局限性。
Extracorporeal membrane oxygenation (ECMO) provides advanced cardiopulmonary life support for patients in cardiac and/or respiratory failure. Echocardiography provides essential diagnostic and anatomic information prior to ECMO initiation, allows for safe and efficient ECMO cannula positioning, guides optimization of flow, provides a modality for rapid troubleshooting and patient evaluation, and facilitates decision-making for eventual weaning of ECMO support. Currently, guidelines for echocardiographic assessment in this clinical context are lacking. In this review, we provide an overview of echocardiographic considerations for advanced imagers involved in the care of these complex patients. We focus predominately on new cannulas and complex cannulation techniques including a special focus on double lumen cannulas and a section discussing indirect left ventricular venting. Echocardiography is tremendously valuable in providing optimal care in these challenging clinical situations. It is imperative for imaging physicians to understand the pertinent anatomic considerations, the often complicated physiological and hemodynamic context, and the limitations of the imaging modality.
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