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Table 1 Parameters to be assessed prior to extracorporeal membrane oxygenation initiation

From: Echocardiography for adult patients supported with extracorporeal membrane oxygenation

Left ventricle

 Morphology

Size, wall thickness

 Systolic function

Ejection fraction (Simpson’s method) or FAC

Wall motion abnormalities

S wave at mitral annulus

Velocity time integral in LVOT

 Diastolic function

E/A ratio (trans-mitral flow)

E/e’ ratio at mitral annulus

 Left atrium

Size and volume

 Valvular assessment

Diagnosis and quantification of potential aortic/mitral regurgitation/stenosis

Right ventricle

 Morphology

RV end diastolic area/LV end diastolic area

Triangular shape versus rounded shape of apex

RV wall thickness

McConnell’s sign

 Systolic function

TAPSE, tissue Doppler at tricuspid annulus, S wave

Fractional area of change

Pulse wave Doppler through pulmonary valve (acceleration time/biphasic pattern)

 Diastolic function

E/A trans-tricuspid flow

 Interventricular septum

Presence of paradoxical septum

Eccentricity index

 Tricuspid regurgitation

Estimation of right ventricular systolic pressure

 Valvular pathology

 Right atrium

Size and volume

Other

 Patent foramen ovale

Color flow Doppler ± bubble study

 IVC/SVC (if TEE)

Size and respiratory variation

 Right atrium

Dilated coronary sinus

Chiari network

 Vascular

Thrombosis/stenosis/aortic dissection/severe atheroma

  1. E/A early diastolic peak velocity/diastolic ventricular filling with atrial contraction, E/e’ early diastolic peak velocity/early diastolic tissue Doppler velocity, FAC fractional area change, IVC inferior vena cava, LV left ventricle, LVOT left ventricular outflow tract, RV right ventricle, SVC superior vena cava, TAPSE tricuspid annular plane systolic excursion, TEE transesophageal echocardiography