Portable CT Pulmonary Angiogram in an Infant on Veno-Arterial Extracorporeal Membrane Oxygenation in the Pediatric Intensive Care Unit
| Autor: | Bradley S. Rostad, Atul Vats, Nikhil K. Chanani, Simon S. Ho, Renee M. Mansour, Meral M. Patel |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Computed Tomography Angiography Iohexol Point-of-Care Systems medicine.medical_treatment Contrast Media Intensive Care Units Pediatric 030218 nuclear medicine & medical imaging law.invention Diagnosis Differential 03 medical and health sciences Extracorporeal Membrane Oxygenation 0302 clinical medicine law Intensive care medicine Extracorporeal membrane oxygenation Humans Radiology Nuclear Medicine and imaging Computed tomography angiography Heart Failure Pediatric intensive care unit medicine.diagnostic_test business.industry Infant medicine.disease Intensive care unit surgical procedures operative Echocardiography Pneumonia Necrotizing 030220 oncology & carcinogenesis Heart failure Radiology Bolus (digestion) business medicine.drug |
| Zdroj: | Current Problems in Diagnostic Radiology. 48:189-192 |
| ISSN: | 0363-0188 |
| DOI: | 10.1067/j.cpradiol.2017.10.005 |
| Popis: | Purpose Computed tomography (CT) has been shown to change management in children on extracorporeal membrane oxygenation (ECMO). Although techniques have been described to transport these critically ill patients to the CT suite in the radiology department, transport out of the intensive care setting is not without risk, and using portable CT is a practical alternative. However, obtaining a CT pulmonary angiogram (CTPA) in a patient on veno-arterial (VA) ECMO presents unique challenges due to bypass of the cardiopulmonary system, which may lead to suboptimal opacification of the pulmonary arteries. Methods We describe a method to obtain a diagnostic CTPA study in an infant on VA ECMO in the intensive care unit using portable CT. Our solution involved temporary withholding ECMO and using the venous cannula to deliver a compact contrast bolus to the right atrium to adequately opacify the pulmonary arteries. Special attention was given to the delivery of the contrast bolus, which was given by hand injection, to ensure it coincided with image acquisition and minimized the time ECMO was withheld. Results We were able to successfully obtain a diagnostic CTPA study in an infant on VA ECMO in the intensive care unit using portable CT. Conclusion: This case demonstrates that in select instances CTPA in infants on VA ECMO can be achieved using a portable CT system. |
| Databáze: | OpenAIRE |
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