ID:10 FC-D07-5 Radiological Interpretation of ECMO and Short-Term Mechanical Circulatory Support Devices: Practical Imaging Considerations

Background: Portable chest radiography (CXR) is routinely used in the care of critically ill patients supported with extracorporeal membrane oxygenation (ECMO) and short-term mechanical circulatory support (MCS) devices. Imaging reports often confirm device presence without clearly addressing whether positioning is appropriate or concerning. Practical, device-specific radiographic guidance remain limited, and interpretation is frequently shared between radiologists and critical care physicians. This educational exhibit was developed to illustrate common patterns of correct and incorrect device positioning using bedside imaging. Activities: Using cases from our center, we present examples of current positioning and malposition of veno-venous and veno-arterial ECMO, as well as left and right sided MCS devices, including Impella and Protek Duo systems. Portable chest radiographs are used to demonstrate key anatomical landmarks, expected device depth, and port orientation. Selected computed tomography images are included when radiographic interpretation is challenging. Device-specific complications related to malposition are highlighted. Discussion: In the absence of standardized radiographic criteria, assessment of device postion can be inconsistent. A shared, multidisciplinary approach to image interpretation allows earlier recognition of malposition and supports timely corrective action in unstable patients. Conclusion: This center-based educational exhibit provides practical imaging examples to support consistent interpretation of ECMO and MCS device positioning, with the goal of improving bedside decision-making and patient safety.