Pediatric Neuromuscular Paralysis

  • Etiology: Pharmacologically induced to prevent patient from fighting ventilation or removing extracorporeal membrane oxygenation catheters
  • Imaging:
    — Extensive body wall edema due to lack of normal intercostal muscle contractions
    — Bell-shaped chest
  • DDX:
  • Complications:
  • Treatment: Resolves once off of pharmacological paralysis
  • Clinical:

Radiology Cases of Neuromuscular Paralysis

Radiology Cases of Neuromuscular Paralysis on Extracorporeal Membrane Oxygenation

CXR of neuromuscular paralysis
CXR AP shows extensive body wall edema and poorly expanded lungs with the tip of the ECMO venous canula in the right atrium (ra) and the tip of the ECMO arterial canula in the aortic arch (aa).

Radiology Cases of Neuromuscular Paralysis on Extracorporeal Membrane Oxygenation With a Malpositioned Venous Catheter Tip

CXR of malposition ECMO catheter in patient with congenital diaphragmatic hernia
CXR shows normal position of the arterial catheter tip in the aortic arch and abnormal position of the venous catheter tip (represented by a radio-opaque point) in the superior vena cava. Further advancement of the tip into the right atrium is necessary. Multiple cystic structures are present in the left hemithorax. The lungs are densely opacified.
CXR of arterial-venous extracorporeal membrane oxygenation (ECMO)
CXR shows normal position of the arterial catheter tip in the aortic arch and abnormal position of the venous catheter tip (represented by a radio-opaque point) in the superior vena cava. Further advancement of the tip into the right atrium is necessary.