Can we reduce anesthesia exposure? Neonatal brain MRI: Swaddling vs. sedation, a national survey

Heller, Benjamin J.; Yudkowitz, Francine S.; Lipson, Scott

doi:10.1016/j.jclinane.2017.01.034

Cited by 40 publications

(17 citation statements)

References 22 publications

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“…One such technique developed to evaluate the efficacy of obtaining images without sedation is the feed and wrap technique. 32,33 The feed and wrap technique refers to the feeding and swaddling of an infant. This technique induces natural sleep in an infant to obtain quality MRI images.…”

Section: Pediatricsmentioning

confidence: 99%

“…Studies have demonstrated that the feed and wrap technique has been a primary technique in neonatal intensive care units across the US and can be used successfully in infants undergoing MRI. 32,33 The combination of the remote nature of NORA and the diversity of patients in the pediatric population provides a unique challenge to anesthesia providers. Anesthesiologists should consider the factors discussed above in creating an anesthesia management plan for pediatrics.…”

Section: Pediatricsmentioning

confidence: 99%

See 1 more Smart Citation

<p>Non-Operating Room Anesthesia: Patient Selection and Special Considerations</p>

Wong¹,

Georgiadis²,

Urman³

et al. 2020

LRA

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Non-operating room anesthesia (NORA) represents a growing field of medicine with an increasing trend in the number of cases performed over the previous decade. As a result, anesthesia providers will need to enhance their familiarity with the resources, personnel, and environment outside of the operating room. Anesthesia delivery in NORA settings should be held with the same high-quality standards as that within the operating room. This review looks at special considerations in patient selection and the preoperative, intraoperative, and postoperative periods. In addition, there is a discussion on the unique aspects of specific NORA areas and the considerations that come with them.

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Section: Pediatricsmentioning

confidence: 99%

Section: Pediatricsmentioning

confidence: 99%

<p>Non-Operating Room Anesthesia: Patient Selection and Special Considerations</p>

Wong¹,

Georgiadis²,

Urman³

et al. 2020

LRA

View full text Add to dashboard Cite

show abstract

“…In a national survey of NICUs published in 2017, Heller et al reported that 64% of responding NICUs in the United States used a feed and swaddle approach to facilitate MRI . The remaining NICUs reported using sedation with midazolam, propofol, chloral hydrate, or rarely general anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Experience with a “Feed and Swaddle” program in infants up to six months of age

Templeton

Norton

Goenaga‐Díaz

et al. 2019

Acta Anaesthesiol Scand

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Background Feed and swaddle is a technique in which an infant is fed and allowed to fall asleep to facilitate diagnostic imaging. This study reviews our experience and diagnostic success in premature and term infants up to 6 months old undergoing brain magnetic resonance imaging (MRI) using a feed and swaddle technique and with comparable patients imaged under anesthesia. Methods We reviewed the charts of all infants ≤6 months who underwent brain MRI at our institution between 1 January 2013 and 31 March 2016. We recorded and analyzed demographic information, scan indication, scan length, prematurity status, anesthetic technique if used, complications, and diagnostic success or failure. Results One hundred and sixty‐four term infants underwent brain MRI using a feed and swaddle technique. The success rate in term infants <90 days was 91.1% (113/124) versus 95.0% (38/40) in infants ≥90 days and ≤181 days old. Fifty‐three premature infants underwent feed and swaddle for brain MRI with a diagnostic success rate of 92.5% (49/53). No complications were noted in any feed and swaddle patients. Those who received anesthesia had a diagnostic success rate of 100% (70/70) but experienced complications including hypoxemia, 14.3% (10/70); hypothermia, 18.9% (10/53); bradycardia, 10.1% (7/69); and hypotension, 4.2% (3/70). Conclusion Given the high rate of success and absence of complications with feed and swaddle in children ≤6 months for brain MRI and the presence of anesthesia‐related complications, most infants should undergo a trial of feed and swaddle prior to undergoing brain MRI with anesthesia.

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“…It allows assessment of structure, function, and morphology, with high soft‐tissue contrast and multiplanar capabilities without the use of ionizing radiation. MRI is being increasingly used for the evaluation of diseases in children . However, children have a difficult time tolerating MR studies due to long scan times, and a frightening environment with loud noises.…”

mentioning

confidence: 99%

“…MRI is being increasingly used for the evaluation of diseases in children. 1 However, children have a difficult time tolerating MR studies due to long scan times, and a frightening environment with loud noises. Most young children under the age of six find it difficult to lie still and follow breathing instructions.…”

mentioning

confidence: 99%

Techniques for minimizing sedation in pediatric MRI

Dong

Zhu

Bulas

2019

Magnetic Resonance Imaging

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MRI is used widely in infants and young children. However, in these young cases deep sedation or general anesthesia is often required to minimize motion artifacts during MRI examinations. Although the benefits of MR typically outweigh the potential risks of sedation when delivered by an experienced team, there are increasing concerns regarding the affect of sedation on young children. There continues to be a push to develop various strategies that can minimize the need for sedation. The present review summarizes several technical and clinical approaches that can help decrease the need for sedation in the pediatric patient. Optimization of the MRI environment, the role of child life specialists, feed‐and‐bundle and distraction techniques, noise‐reduction methods, artificial intelligence, and MRI advances to decrease both scan times and motion artifacts will be discussed. Level of Evidence: 5 Technical Efficacy Stage: 1 J. Magn. Reson. Imaging 2019.

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Can we reduce anesthesia exposure? Neonatal brain MRI: Swaddling vs. sedation, a national survey

Cited by 40 publications

References 22 publications

<p>Non-Operating Room Anesthesia: Patient Selection and Special Considerations</p>

<p>Non-Operating Room Anesthesia: Patient Selection and Special Considerations</p>

Experience with a “Feed and Swaddle” program in infants up to six months of age

Techniques for minimizing sedation in pediatric MRI

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