Presentation
Multifocal 3rd-degree burns, ARDS and ECMO. Intensive care setting.
Patient Data
The mobile X-ray demonstrates venoarterial (VA) ECMO cannulae. There is the right IJV access SVC cannula and the right common carotid (CCA) access "arterial" cannula.
The lung fields are underinspired with multifocal ill-defined parenchymal opacification and ground glass opacity with air bronchograms in a setting of ARDS. The cardiomediastinal contour is ill-defined. The endotracheal tube (ETT) tip is at the mid-T3 vertebral body level. There is a left IJV access central venous catheter (CVC) satisfactorily sited. The nasogastric tube (NGT) is satisfactorily sited.
There are bilateral, symmetric, humeral periosteal reactions likely related to the lung disease.
Case Discussion
The child is ventilated in an intensive care setting with multifocal 3rd-degree burns, and ARDS.
There is cardiorespiratory support via the presence of venoarterial extracorporeal membrane oxygenation (VA ECMO) as demonstrated by the presence of a venous (SVC) and an arterial (right CCA) cannula.
There are bilateral, symmetric, smooth humeral periosteal reactions which may represent a combination of physiological and lung disease-related aetiology (hypertrophic pulmonary-related osteoarthropathy or HPOA).
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