ABSTRACT
La ecografía es un instrumento diagnóstico fundamental en el paciente crítico con membrana de oxigenación extracorpórea (ECMO). Con ella podemos hacer una evaluación anatómica y funcional (cardiaca, pulmonar y vascular) para plantear una adecuada configuración; además, guía su implante, ayuda en la monitorización clínica y la detección de complicaciones, facilita su retirada y completa la evaluación postimplante. En los pacientes con ECMO como soporte respiratorio (veno-venosa), la ecografía torácica permite monitorizar la evolución de la enfermedad pulmonar y la ecocardiografía la evaluación de la función biventricular, especialmente la derecha, y el gasto cardiaco para optimizar el transporte de oxígeno. En la ECMO como soporte circulatorio (veno-arterial), la ecocardiografía supone la guía de la monitorización hemodinámica, permite detectar las principales complicaciones y ayuda al destete del dispositivo. En los equipos ECMO, para un adecuado manejo de estos pacientes, debe haber intensivistas entrenados y con conocimientos avanzados sobre esta técnica. (AU)
Ultrasound is an essential diagnostic tool in critically ill patients with extracorporeal membrane oxygenation (ECMO). With it, we can make an anatomical and functional (cardiac, pulmonary and vascular) evaluation which allows us to execute an adequate configuration, guides implantation, helps clinical monitorization and detects complications, facilitates withdrawal and complete post-implant evaluation. In patients with ECMO as respiratory support (veno-venous), thoracic ultrasound allows monitoring pulmonary illness evolution and echocardiography the evaluation of biventricular function, especially right ventricle function, and cardiac output to optimize oxygen transport. In ECMO as circulatory support (veno-arterial), echocardiography is the guide of hemodynamic monitoring, allows detecting the most frequent complications and helps the weaning. In ECMO teams, for a proper management of these patients, there must be trained intensivists with advanced knowledge on this technique. (AU)
Subject(s)
Humans , Ultrasonography/methods , Ultrasonography/trends , Extracorporeal Membrane Oxygenation , Echocardiography , Hemodynamic Monitoring , Monitoring, PhysiologicABSTRACT
Ultrasound is an essential diagnostic tool in critically ill patients with extracorporeal membrane oxygenation (ECMO). With it, we can make an anatomical and functional (cardiac, pulmonary and vascular) evaluation which allows us to execute an adequate configuration, guides implantation, helps clinical monitorization and detects complications, facilitates withdrawal and complete post-implant evaluation. In patients with ECMO as respiratory support (veno-venous), thoracic ultrasound allows monitoring pulmonary illness evolution and echocardiography the evaluation of biventricular function, especially right ventricle function, and cardiac output to optimize oxygen transport. In ECMO as circulatory support (veno-arterial), echocardiography is the guide of hemodynamic monitoring, allows detecting the most frequent complications and helps the weaning. In ECMO teams, for a proper management of these patients, there must be trained intensivists with advanced knowledge on this technique.
