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Updated: Jan 14, 2026
Point-of-Care Ultrasound for Peripheral Veno-Arterial Extracorporeal Membrane Oxygenation Without Left Ventricular Venting
Published on: January 17, 2025
A scoping review: Point-of-care ultrasound (POCUS) use in paediatric ECMO
Catia Pinto1, Alex Williams1, Jon Lillie1,2
1Paediatric Intensive Care Unit, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Insights
Point-of-care ultrasound (POCUS) use is growing in pediatric extracorporeal membrane oxygenation (ECMO) care, but evidence is limited. Standardized guidelines and more research are needed for safe integration.
Area of Science:
- Pediatric Critical Care Medicine
- Point-of-Care Ultrasound (POCUS)
- Extracorporeal Membrane Oxygenation (ECMO)
Background:
- Point-of-care ultrasound (POCUS) is increasingly utilized in various medical fields.
- Extracorporeal membrane oxygenation (ECMO) provides life support for critically ill pediatric patients.
- The application of POCUS in pediatric ECMO patients requires specific consideration due to unique physiological challenges.
Purpose of the Study:
- To conduct a scoping review of current literature on POCUS use in pediatric ECMO.
- To assess the existing evidence base, summarize key findings, and identify limitations.
- To explore knowledge gaps regarding POCUS application in this specialized patient population.
Main Methods:
- Comprehensive literature search across major databases (Medline, CINAHL, Embase, Cochrane Library).
- Inclusion criteria: pediatric patients (0-18 years) on any form of extracorporeal life support.
- Exclusion criteria: in-utero interventions and non-POCUS scans; data extraction and narrative/tabular presentation.
Main Results:
- Literature indicates a rising trend in POCUS utilization within pediatric ECMO settings.
- The evidence base is currently limited and characterized by heterogeneity.
- Direct extrapolation of findings from non-ECMO studies is challenging due to physiological differences in ECMO patients.
Conclusions:
- POCUS shows increasing adoption in pediatric ECMO, yet the evidence remains sparse and varied.
- Lack of standardized protocols and governance frameworks impacts consistency and reliability.
- Development of unified guidelines and robust pediatric-specific research is crucial for safe and effective POCUS integration.
Abstract:
ObjectiveThis scoping review aimed to examine current literature on the use of point-of-care ultrasound (POCUS) in paediatric patients supported by extracorporeal membrane oxygenation (ECMO). It assessed existing evidence, summarised key findings, explored theoretical limitations, and identified knowledge gaps.MethodsA comprehensive search of Medline, CINAHL, Embase, and the Cochrane Library was conducted using a strategy developed with an academic librarian. Studies involving patients aged 0-18 years receiving any form of extracorporeal life support were included; in-utero interventions and non POCUS scans were excluded. Data on participants, context, concepts, study design, and outcomes were extracted and presented in tabular and narrative form.ConclusionThis review highlights the increasing use of POCUS in paediatric ECMO care, despite a limited and heterogeneous evidence base. Physiological differences in ECMO patients challenge the direct application of findings from non-ECMO studies. The absence of standardised protocols and governance frameworks limits consistency and reliability. Developing unified guidelines and strengthening paediatric-specific research are essential to support safe and effective integration of POCUS into clinical practice.
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