Imaging of cerebral complications of extracorporeal membrane oxygenation in infants with congenital heart disease - ultrasound with multimodality correlation

Pediatr Radiol. 2020 Jun;50(7):997-1009. doi: 10.1007/s00247-019-04603-1. Epub 2020 Feb 15.

Abstract

Cranial ultrasound on neonatal intensive care units is generally performed by intensive care physicians, but radiologists often provide this crucial bedside test to children on specialist paediatric cardiac intensive care units. On a paediatric cardiac intensive care unit, complex congenital cardiac conditions are commonly encountered in both pre- and postoperative scenarios, often with the use of extracorporeal membrane oxygenation (ECMO), which both increases the risks of a number of neurologic complications and results in significant changes in vascular physiology. The aim of this pictorial essay is to discuss cranial ultrasound technique, demonstrate the changes in Doppler flow profiles resulting from veno-arterial extracorporeal membrane oxygenation and congenital cardiac conditions, and illustrate commonly encountered intracranial complications of extracorporeal membrane oxygenation support in congenital cardiac care.

Keywords: Brain; Complications; Congenital heart disease; Extracorporeal membrane oxygenation; Neonate; Ultrasound; Vascular imaging.

MeSH terms

  • Brain Injuries / diagnostic imaging*
  • Brain Injuries / etiology*
  • Extracorporeal Membrane Oxygenation / adverse effects*
  • Female
  • Heart Defects, Congenital / therapy*
  • Humans
  • Infant, Newborn
  • Intensive Care Units, Neonatal
  • Male
  • Ultrasonography, Doppler, Transcranial*