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Updated: Apr 17, 2026
Point-of-Care Ultrasound for Peripheral Veno-Arterial Extracorporeal Membrane Oxygenation Without Left Ventricular Venting
Published on: January 17, 2025
Extracorporeal membrane oxygenation: a radiologists' guide to who, what and where
S R Hosmane1, T Barrow1, A Ashworth1
1University Hospital of South Manchester, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK.
Insights
Extracorporeal membrane oxygenation (ECMO) provides life support for severe respiratory and cardiac failure. This review details ECMO
Area of Science:
- Critical Care Medicine
- Radiology
- Cardiopulmonary Support
Background:
- Extracorporeal membrane oxygenation (ECMO) is a vital short-term support for severe respiratory or cardiac failure.
- Its application in severe acute respiratory distress syndrome (ARDS) is now standard practice, supported by trials like CESAR.
- Radiological assessment is crucial for patients on ECMO, necessitating understanding of device appearances and complications.
Purpose of the Study:
- To review the uses, subtypes, physiology, and normal radiological appearances of ECMO.
- To highlight common complications associated with ECMO in severe respiratory failure patients.
- To emphasize the importance of recognizing normal ECMO imaging findings in the perioperative period.
Main Methods:
- Literature review of ECMO applications, focusing on severe ARDS.
- Analysis of radiological findings in patients undergoing ECMO therapy.
- Inclusion of perioperative radiographic examples to illustrate key imaging features.
Main Results:
- ECMO offers significant survival benefits for ARDS patients, as shown by the CESAR trial.
- Radiological examinations are frequent in this patient group.
- Understanding ECMO's normal and abnormal appearances is essential for radiologists.
Conclusions:
- ECMO is an established treatment for severe respiratory and cardiac failure.
- Radiologists must be familiar with ECMO devices and their potential complications.
- Accurate interpretation of ECMO-related imaging is critical for patient management.
Abstract:
Extracorporeal membrane oxygenation (ECMO) is the short-term (days to weeks) support of patients with severe respiratory and/or cardiac failure. The use of these devices has been well established in paediatric and post-heart and lung transplantation patients; however, its use in patients with severe acute respiratory distress syndrome (ARDS) has gained acceptance as standard clinical practice over the past decade. The results of the CESAR trial (Conventional ventilation or ECMO for Severe Adult Respiratory failure) showed significant survival benefit for patients with ARDS undergoing ECMO. Substantial numbers of radiological examinations are performed in this patient group, prompting the need for general radiologists to understand the radiological appearances of these devices and associated complications. In this review, we highlight the uses, subtypes, physiology, normal appearances, and complications of ECMO. An example of the chronological radiographic images in the perioperative period demonstrates the importance of discriminating normal appearances associated with EMCO.
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