ECMO catheters in a neonate

Case contributed by Dr Jeremy Jones

Presentation

Profound hypoxia despite maximal ventilatory support.

Patient Data

Age: 3 days
Gender: Male
X-ray

Multiple mediastinal lines and tubes in a neonate (confirmed by umbilical lines).  It is important to be aware of what these lines are and where they should be.  It's always worth considering lines and tubes first when reviewing any radiograph.

Annotated image
  • airway (turquoise)
  • ECMO x2 (light blue)
  • NG (yellow)
  • temperature (purple)
  • UAC (red)
  • UVC (blue)
  • left ICC (green)

Case Discussion

It's always worth identifying all lines and tubes, especially on ITU/NNU chest radiographs before embarking on the rest of the film.

The lines and tube, include in ECMO catheters are in appropriate positions.  The background lungs demonstrate interstitial opacification, but no confluent consolidation or collapse and no significant residual effusion.

The differential for the background lung disease is wide and includes cardiac failure, infection and inflammatory causes.  Since this child is only 3 day old, TTN is a possibility.  However, the ventilatory failure is profound despite a relatively benign looking chest radiograph.

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Case information

rID: 23851
Case created: 13th Jul 2013
Last edited: 15th Oct 2015
Systems: Chest, Paediatrics
Tag: devices
Inclusion in quiz mode: Included

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