{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:54:10Z","timestamp":1783385650324,"version":"3.54.6"},"reference-count":10,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2021,3,26]],"date-time":"2021-03-26T00:00:00Z","timestamp":1616716800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Perfusion"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Point-of-care ultrasound (POCUS) is widely utilized to make timely decisions regarding patient care. This approach allowed us to diagnose the cause of acutely rising transaminases in a patient in severe ARDS secondary to influenza pneumonia requiring veno-venous extracorporeal membrane oxygenation (VV-ECMO).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case report:<\/jats:title>\n                    <jats:p>\n                      A 36-year-old female presented with acute hypoxemic respiratory failure secondary to influenza A infection. Within 24\u2009hours, she required intubation and met severe ARDS criteria with a PaO\n                      <jats:sub>2<\/jats:sub>\n                      \/FiO\n                      <jats:sub>2<\/jats:sub>\n                      ratio of 62. She was managed with high PEEP and low tidal volume ventilation strategy, however her clinical status continued to deteriorate and the decision was made to pursue VV-ECMO. Within hours of cannulation her aspartate aminotransferase (AST) dramatically increased from 736 to 4512\u2009\u00b5\/L, with concurrent mild increases in alanine aminotransferase (ALT) and creatine phosphokinase (CPK). Point-of-care ultrasound was performed which revealed a complete absence of flow in the hepatic vein, secondary to acute obstruction by an 25-French drainage catheter for the ECMO circuit. The catheter was exchanged with a smaller French catheter and the patient\u2019s transaminases and CPK levels quickly decreased and returned to normal within several days.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>Budd-Chiari syndrome (BCS) is a rare but potentially life-threatening condition caused by acute obstruction of hepatic vein blood flow that can lead to fulminant liver failure if left untreated. BCS is usually caused by a hepatic vein thrombus, however any mechanical obstruction can lead to the same pathology. Point-of-care ultrasound lead to a prompt diagnosis and allowed for quick action to correct the obstruction. Although BCS is not a common problem with VV-ECMO, the syndrome should always be on the differential of any patient on VV-ECMO with acutely rising transaminases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Ultrasound played an integral role in providing a crucial diagnosis of BCS secondary to obstruction by an ECMO drainage catheter.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02676591211003874","type":"journal-article","created":{"date-parts":[[2021,3,26]],"date-time":"2021-03-26T05:29:20Z","timestamp":1616736560000},"page":"530-532","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Acute Budd Chiari syndrome in an ECMO patient"],"prefix":"10.1177","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9276-2381","authenticated-orcid":false,"given":"Ryan","family":"Butzko","sequence":"first","affiliation":[{"name":"Department of Pulmonary, Critical Care and Sleep Medicine, Northwell Health, Long Island Jewish Medical Center, New Hyde Park, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mangala","family":"Narasimhan","sequence":"additional","affiliation":[{"name":"Department of Pulmonary, Critical Care and Sleep Medicine, Northwell Health, Long Island Jewish Medical Center, New Hyde Park, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,3,26]]},"reference":[{"key":"bibr1-02676591211003874","unstructured":"Deane C. Doppler ultrasound: principles and practice, https:\/\/sonoworld.com\/Client\/Fetus\/html\/doppler\/capitulos-html\/chapter_01.htm (accessed 21 January 2021)."},{"key":"bibr2-02676591211003874","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v13.i13.1912"},{"key":"bibr3-02676591211003874","first-page":"17","volume":"3","author":"Gowda S","year":"2009","journal-title":"Pan Afr Med J"},{"key":"bibr4-02676591211003874","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.1040752"},{"key":"bibr5-02676591211003874","doi-asserted-by":"publisher","DOI":"10.1111\/apt.15149"},{"key":"bibr6-02676591211003874","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-018-4079-y"},{"key":"bibr7-02676591211003874","volume":"98","author":"Kim JH","year":"2019","journal-title":"Medicine (Baltimore)"},{"key":"bibr8-02676591211003874","doi-asserted-by":"publisher","DOI":"10.12659\/AJCR.906452"},{"key":"bibr9-02676591211003874","doi-asserted-by":"publisher","DOI":"10.1007\/s13181-010-0075-9"},{"key":"bibr10-02676591211003874","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e31827a0a36"}],"container-title":["Perfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02676591211003874","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/02676591211003874","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02676591211003874","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T17:30:15Z","timestamp":1777656615000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/02676591211003874"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,26]]},"references-count":10,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,7]]}},"alternative-id":["10.1177\/02676591211003874"],"URL":"https:\/\/doi.org\/10.1177\/02676591211003874","relation":{},"ISSN":["0267-6591","1477-111X"],"issn-type":[{"value":"0267-6591","type":"print"},{"value":"1477-111X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,26]]}}}