Echocardiography (ECHO) is an essential diagnostic tool for patients who require extracorporeal membrane oxygenation (ECMO). ECMO provides oxygenation and circulatory support to patients with severe cardiac/respiratory dysfunction. ECHO plays an important role in the management and evaluation of ECMO therapy. ECHO is a relatively noninvasive imaging technique that uses high-frequency sound waves to produce detailed imaging of the heart's structure and functionality. It is used to evaluate various aspects of cardiac function, including cardiac output, ejection fraction (EF), regional wall motion abnormalities (RWMA), and valvular function. ECHO provides vital information about the cardiopulmonary physiological response to ECMO therapy. Apart from helping identify intra and extracardiac thrombi and clots, it is used for the assessment of ECMO cannula placement to optimize blood flow mechanics and gas exchange. One of the advantages of ECHO in ECMO support is its versatility in providing real-time feedback that enables clinicians to optimize therapy and mitigate potential complications during the ECMO run. ECHO helps diagnose and quantify conditions that cause hemodynamic instability, such as undiagnosed valvular lesions, ventricular dysfunction, and aortic dissection. Epiaortic ECHO provides information about aortic atheroma and aids in selecting the best site for aortic cannulation. The placement of venous cannula for venovenous (VV)—ECMO or venoarterial (VA)—ECMO can be affected by anatomical abnormalities of the heart such as left-sided superior vena cava (SVC), Chiari network, prominent eustachian valve, atrial septal defect (ASD) all of which can be diagnosed by ECHO.
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