Children and Neonates Anesthesia in Magnetic Resonance Environment in Italy. An active Call Survey

Abstract

Background Pediatric anesthesia care in the Magnetic Resonance Imaging is a challenge for clinicians. The recent debate about the role of anesthetic agent on neural development, encouraged an evaluation of their actual activity in this environment. In this active call survey, the authors sought to delineate the Italian situation regarding national centers, staff involved, monitoring and tools available.Methods A complete sample of all national centers performing almost a pediatric discharge in the 2014 was obtained from Health Ministery registers. All Institution were contacted for a prospective phone investigation and a three section survey was fill out with the Physician in charge. A descriptive and exploratory analyses about the organization setting of the Centers (procedures, performers, monitoring and tools) were performed. Results Among 876 Institution screened, only 106 (37%) met minimal criteria for inclusion. Children are managed by anesthesiologists in the 95% of cases, while neonates in the 54%. A dedicated nurse is present in 74% of centers. While a pulse oximetry is present in 100% of centers, the rate of prevalence of other monitoring is lower (EKG94%; EtCO283%; Blood Pressure65%). A specific MRI-compatible ventilator is available in the 95% of Centers, but many tools are not equally homogenously distributed: Halogenated Vaporizers (82%), Scavenger System (72%), Suction devices (95%), non-magnetic infusion pumps (38%). Conclusions Our results could be a starting point to evaluate the further evolution of approach to children and neonates in magnetic resonance setting. Staff involved is generally qualified, but monitoring availability is unsatisfactory in many Centers.