Lidegran Marika, Palmér Kenneth, Jorulf Håkan, Lindén Viveka
Department of Paediatric Radiology, Astrid Lindgren Children's Hospital, Karolinska Hospital, Karolinska Institute, 17176 Stockholm, Sweden.
Pediatr Radiol. 2002 Aug;32(8):567-74. doi: 10.1007/s00247-002-0756-x. Epub 2002 Jun 21.
In patients with acute severe respiratory failure (ARF) treated with extracorporeal membrane oxygenation (ECMO) the radiological evaluation has until now almost exclusively relied on bedside radiography and US. At St. Göran/Karolinska ECMO centre CT has become a routine complement to bedside examinations.
To review retrospectively the frequency, indications and findings on CT of patients with ARF on ECMO and to evaluate the risk of complications associated with transportation for CT examinations.
One hundred twelve neonates, children and adults were treated with ECMO from May 1994 to January 2001. Forty-six per cent of these patients had CT examinations on one or more occasions during ECMO, giving a total number of 238 examination sites on 104 occasions. All CT examinations were performed in the Paediatric Radiology Department and included a 10-min transport using a mobile ECMO system.
CT was more often performed in older patients and in patients with long ECMO runs. The main indications were suspected complications of ECMO and/or the underlying disease or a delay in clinical improvement. In 57% of the CT occasions, significant findings affecting treatment were revealed. There were no complications associated with the examinations or transport.
CT is safe and useful in evaluation of patients with ARF during ECMO.
在接受体外膜肺氧合（ECMO）治疗的急性重症呼吸衰竭（ARF）患者中，迄今为止，放射学评估几乎完全依赖于床边X线摄影和超声检查。在圣戈兰/卡罗林斯卡ECMO中心，CT已成为床边检查的常规补充手段。
回顾性分析接受ECMO治疗的ARF患者CT检查的频率、适应证及检查结果，并评估CT检查转运过程中相关并发症的风险。
1994年5月至2001年1月，112例新生儿、儿童及成人接受了ECMO治疗。其中46%的患者在ECMO治疗期间接受了1次或多次CT检查，共进行了104次检查，检查部位达238个。所有CT检查均在儿科放射科进行，使用移动ECMO系统进行10分钟的转运。
年龄较大的患者及接受ECMO治疗时间较长的患者更常接受CT检查。主要适应证为怀疑ECMO和/或基础疾病的并发症或临床改善延迟。在57%的CT检查中，发现了影响治疗的重要结果。检查及转运过程中均未出现并发症。
CT检查对于评估接受ECMO治疗的ARF患者安全且有用。
