Acute Congestive Hepatopathy, Diagnosed With Point-of-Care Hepatic Ultrasound in a Patient on Extracorporeal Membrane Oxygenation

• Ultrasound is a valuable tool for interrogating cannula position in ECMO patients. • RV dysfunction is common in patients with COVID-19 ARDS. • Consider insidious RV dysfunction when changing central ECMO flow rates. • Direct hepatic venous spectral Doppler evaluation may help to optimize ECMO settings. • Ultrasound may be helpful in diagnosing congestive hepatopathy in central ECMO.