Portable CT pulmonary angiogram in an infant on veno-arterial extracorporeal membrane oxygenation in the pediatric intensive care unit

Publication date: Available online 31 October 2017
Source:Current Problems in Diagnostic Radiology
Author(s): Simon Ho, Meral Patel, Renee Mansour, Atul Vats, Nikhil Chanani, Bradley S. Rostad
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. Here we describe a method to obtain a diagnostic CTPA study in an infant on VA ECMO in the intensive care unit using portable CT. This case demonstrates that in select instances CTPA in infants on VA ECMO can be achieved using a portable CT system.



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