A scoping review: Point-of-care ultrasound (POCUS) use in paediatric ECMO

Abstract

ObjectiveThis scoping review aimed to examine current literature on the use of point-of-care ultrasound (POCUS) in paediatric patients supported by extracorporeal membrane oxygenation (ECMO). It assessed existing evidence, summarised key findings, explored theoretical limitations, and identified knowledge gaps.MethodsA comprehensive search of Medline, CINAHL, Embase, and the Cochrane Library was conducted using a strategy developed with an academic librarian. Studies involving patients aged 0-18 years receiving any form of extracorporeal life support were included; in-utero interventions and non POCUS scans were excluded. Data on participants, context, concepts, study design, and outcomes were extracted and presented in tabular and narrative form.ConclusionThis review highlights the increasing use of POCUS in paediatric ECMO care, despite a limited and heterogeneous evidence base. Physiological differences in ECMO patients challenge the direct application of findings from non-ECMO studies. The absence of standardised protocols and governance frameworks limits consistency and reliability. Developing unified guidelines and strengthening paediatric-specific research are essential to support safe and effective integration of POCUS into clinical practice.

Keywords: ECMO; POCUS; cannulation; echocardiography; lung ultrasound; paediatric; transcranial doppler.