Children with DS require a higher proportion of organ support than expected by disease severity at ICU admission. In addition, the mortality risk for children with DS is dependent upon length of ICU stay. These findings could reflect differences in case mix, but are also compatible with different response to critical illness in this group.

Although the majority of cases were safe and without incident, the complication rate in children with CHD receiving a GA for CMR is higher than in the general pediatric population. This reinforces the need for a senior, multidisciplinary team to be involved in the care of these children during imaging.

Background: Poor organ perfusion results in tissue ischaemia and creates an oxygen debt. These events are linked to subsequent development of organ failure, prolonged hospital stay and death 1,2. Identifying patients at risk of tissue ischaemia and providing appropriate resuscitation may reduce morbidity and mortality 3-8 .