CTICasesDiffuse Pulmonary Hemorrhage on Venovenous ECMO Support
Imaging findings
Chest CT demonstrates diffuse, bilateral pulmonary consolidation and ground-glass opacities, which was confirmed on bronchoalveolar lavage to represent diffuse pulmonary hemorrhage. Dual large cannulas are seen in the inferior vena cava and right atrium/superior vena cava, indicating venovenous extracorporeal membrane oxygenation support.
Key takeaways
Diffuse pulmonary hemorrhage is a rare and life-threatening perioperative complication of cardiac surgery. When acute respiratory distress syndrome or severe respiratory failure limits mechanical ventilation, venovenous ECMO can provide essential blood oxygenation. A common VV-ECMO configuration utilizes two separate cannulas (drainage and reinfusion) that must be appropriately separated within the vena cavae and right atrium to prevent recirculation.
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