{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T10:31:21Z","timestamp":1761215481490,"version":"build-2065373602"},"reference-count":46,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,2,16]],"date-time":"2024-02-16T00:00:00Z","timestamp":1708041600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Extracorporeal membrane oxygenation (ECMO) is indicated for patients with severe respiratory and\/or circulatory failure. The standard technique to visualize the extent of pulmonary damage during ECMO is computed tomography (CT). Purpose: This single-center, retrospective study investigated whether pulmonary blood flow (PBF) measured with echocardiography can assist in assessing the extent of pulmonary damage and whether echocardiography and CT findings are associated with patient outcomes. Methods: All patients (&gt;15 years) commenced on ECMO between 2011 and 2017 with septic shock of pulmonary origin and a treatment time &gt;28 days were screened. Of 277 eligible patients, 9 were identified where both CT and echocardiography had been consecutively performed. Results: CT failed to indicate any differences in viable lung parenchyma within or between survivors and non-survivors at any time during ECMO treatment. Upon initiation of ECMO, the survivors (n = 5) and non-survivors (n = 4) had similar PBF. During a full course of ECMO support, survivors showed no change in PBF (3.8 \u00b1 2.1 at ECMO start vs. 7.9 \u00b1 4.3 L\/min, p = 0.12), whereas non-survivors significantly deteriorated in PBF from 3.5 \u00b1 1.0 to 1.0 \u00b1 1.1 L\/min (p = 0.029). Tidal volumes were significantly lower over time among the non-survivors, p = 0.047. Conclusions: In prolonged ECMO for pulmonary septic shock, CT was not found to be effective for the evaluation of pulmonary viability or recovery. This hypothesis-generating investigation supports echocardiography as a tool to predict pulmonary recovery via the assessment of PBF at the early to later stages of ECMO support.<\/jats:p>","DOI":"10.3390\/jcm13041113","type":"journal-article","created":{"date-parts":[[2024,2,16]],"date-time":"2024-02-16T03:37:27Z","timestamp":1708054647000},"page":"1113","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Severe Lung Dysfunction and Pulmonary Blood Flow during Extracorporeal Membrane Oxygenation"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1845-7418","authenticated-orcid":false,"given":"Lars","family":"Falk","sequence":"first","affiliation":[{"name":"ECMO Centre Karolinska, ME Pediatric Perioperative Medicine and Intensive Care, Karolinska University Hospital, Akademiska Straket 14, 171 76 Stockholm, Sweden"},{"name":"Department of Physiology and Pharmacology, Karolinska Institutet, 171 76 Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marika","family":"Lidegran","sequence":"additional","affiliation":[{"name":"Department of Pediatric Radiology, Astrid Lindgren Children\u2019s Hospital, Karolinska University Hospital, 171 76 Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra","family":"Diaz Ruiz","sequence":"additional","affiliation":[{"name":"Department of Pediatric Radiology, Astrid Lindgren Children\u2019s Hospital, Karolinska University Hospital, 171 76 Stockholm, Sweden"},{"name":"Department of Women\u2019s and Children\u2019s Health, Karolinska Institutet, 171 76 Stockholm, Sweden"},{"name":"Department of Radiology, Lund University, 221 00 Lund, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Hultman","sequence":"additional","affiliation":[{"name":"ECMO Centre Karolinska, ME Pediatric Perioperative Medicine and Intensive Care, Karolinska University Hospital, Akademiska Straket 14, 171 76 Stockholm, Sweden"},{"name":"Department of Physiology and Pharmacology, Karolinska Institutet, 171 76 Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4124-4581","authenticated-orcid":false,"given":"Lars Mikael","family":"Broman","sequence":"additional","affiliation":[{"name":"ECMO Centre Karolinska, ME Pediatric Perioperative Medicine and Intensive Care, Karolinska University Hospital, Akademiska Straket 14, 171 76 Stockholm, Sweden"},{"name":"Department of Physiology and Pharmacology, Karolinska Institutet, 171 76 Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,16]]},"reference":[{"key":"ref_1","unstructured":"Brogan, T.V., Lequier, L., MacLaren, G., Lorusso, R., Peek, G.J., Brodie, D., Thiagarajan, R., and Vercaemst, L. 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