Surgery and magnetic resonance imaging increase the risk of hypothermia in infants

Paul, Joel M Don; Perkins, Elizabeth; Pereira‐Fantini, Prue M.; Suka, Asha; Farrell, Olivia; Gunn, Julia; Rajapaksa, Anushi; Tingay, David G.

doi:10.1111/jpc.13824

Cited by 13 publications

(13 citation statements)

References 26 publications

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“…Some studies have looked at the impact of MRI on body temperature in children and infants with mixed results; some findings show hypothermia is frequent postscan. 9,12 Other reports show hyperthermia (body temperature > 38°C) may be a bigger issue in this patient population. 10,11 None of these previous studies have measured temperature continuously throughout the scan.…”

Section: Introductionmentioning

confidence: 78%

Association Between Magnetic Resonance Imaging in Anesthetized Children and Hypothermia

Cronin

Shen

Rana

et al. 2019

Pediatric Quality &Amp; Safety

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Introduction: There is a myriad of factors that can lead to temperature derangements in anesthetized children undergoing magnetic resonance imaging (MRI). Temperature abnormalities in pediatric patients are associated with increased morbidity and mortality. Although some reports have looked at this topic, to our knowledge, no studies have continuously monitored temperature throughout the MRI scan. The purpose of this study is to determine the impact of MRI on body temperature for anesthetized children undergoing MRI using continuous temperature measurement, identify patient risk factors to develop temperature abnormalities, and determine the effect of temperature derangements on perianesthetic complications. Methods: This retrospective, single-center study evaluated 285 pediatric outpatients from January 1, 2018, to March 31, 2018, who were less than 8 years old and underwent anesthesia for an MRI scan. Temperature, postanesthesia care unit length of stay, and demographic data were collected retrospectively using chart review and data extraction from electronic medical records. Statistical analyses included unpaired t test, chi-square test, and simple and multiple linear regressions. Results: Sixty-three percent (179/285) of children in our study had a median temperature less than 36°C during their MRI scan. There were no patients who had a median temperature greater than 38°C during their MRI scan. There were no identifiable patient risk factors for the development of hypothermia. Those who developed hypothermia did not have an increased rate of perianesthetic complications. Conclusion: MRI in anesthetized children is associated with hypothermia but does not correlate with any significant perianesthetic complications.

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Section: Introductionmentioning

confidence: 78%

Association Between Magnetic Resonance Imaging in Anesthetized Children and Hypothermia

Cronin

Shen

Rana

et al. 2019

Pediatric Quality &Amp; Safety

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“…21 Neonates have less isolating subcutaneous fat and a larger surface-to-body weight ratio, making them more prone to develop hypothermia. 21,[24][25][26] The risk of high local peak SAR values in neonates is lower compared with adults because less power is needed in neonates to reach the same B 1 1. Furthermore, the risk of high local peak SAR is reduced by the above-described safety margins (Table 1).…”

Section: Discussionmentioning

confidence: 99%

Introduction of Ultra-High-Field MR Imaging in Infants: Preparations and Feasibility

Annink

Dudink

et al. 2020

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: Cerebral MR imaging in infants is usually performed with a field strength of up to 3T. In adults, a growing number of studies have shown added diagnostic value of 7T MR imaging. 7T MR imaging might be of additional value in infants with unexplained seizures, for example. The aim of this study was to investigate the feasibility of 7T MR imaging in infants. We provide information about the safety preparations and show the first MR images of infants at 7T. MATERIALS AND METHODS: Specific absorption rate levels during 7T were simulated in Sim4life using infant and adult models. A newly developed acoustic hood was used to guarantee hearing protection. Acoustic noise damping of this hood was measured and compared with the 3T Nordell hood and no hood. In this prospective pilot study, clinically stable infants, between termequivalent age and the corrected age of 3 months, underwent 7T MR imaging immediately after their standard 3T MR imaging. The 7T scan protocols were developed and optimized while scanning this cohort. RESULTS: Global and peak specific absorption rate levels in the infant model in the centered position and 50-mm feet direction did not exceed the levels in the adult model. Hearing protection was guaranteed with the new hood. Twelve infants were scanned. No MR imaging-related adverse events occurred. It was feasible to obtain good-quality imaging at 7T for MRA, MRV, SWI, singleshot T2WI, and MR spectroscopy. T1WI had lower quality at 7T. CONCLUSIONS: 7T MR imaging is feasible in infants, and good-quality scans could be obtained. ABBREVIATIONS: dB(A) ¼ A-weighted decibels;-50-mm FH ¼ 50 mm from the isocenter in feet direction; 150-mm FH ¼ 50 mm from the isocenter in head direction; SAR ¼ specific absorption rate

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“…There is a shortage of literature that evaluates neonatal thermal care strategies (10) . This review also reveals that there is a reduced number of publications aimed at preventing hypothermia in NB undergoing a surgical procedure.…”

Section: Discussionmentioning

confidence: 99%

“…Accidental hypothermia is a frequent occurrence during neonatal surgery, which indicates the importance of developing evidence-based warming strategies for prevention (10) . NBs that present hypothermia in the intra and/or postoperative period will have a greater number of AEs when compared to normothermic ones (11) .…”

Section: Introductionmentioning

confidence: 99%

Prevention of hypothermia in newborn submitted to surgical procedures: an integrative review

et al. 2022

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Objective: to discuss in the scientific literature the strategies used to prevent hypothermia in newborns undergoing surgical procedures. Methods this is an integrative literature review, with structured search in April and May 2020 in 08 databases, using the descriptors: Hypothermia; Surgical Procedures, Operative; Infant, Newborn; Protocols. Four primary studies were selected and analyzed using three instruments to assess the methodological quality of the Joanna Briggs Institute and content analysis. Results: Among the strategies used, the following stand out: room temperature control; establishment of humidification and quality of air conditioning cleanliness; use of a heated incubator or cradle; use of thermal mattress; use of caps and blanket; heated fluids; temperature monitoring and abdominal organ coverage. Conclusion good hypothermia prevention strategies were identified, despite the small number of publications on this topic; thus, it points out the need for research with strong evidence.

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Surgery and magnetic resonance imaging increase the risk of hypothermia in infants

Abstract: Unintentional hypothermia is a common occurrence during surgery in the OT and MRI in neonates, indicating that evidence-based warming strategies to prevent hypothermia should be developed.

Cited by 13 publications

References 26 publications

Association Between Magnetic Resonance Imaging in Anesthetized Children and Hypothermia

Association Between Magnetic Resonance Imaging in Anesthetized Children and Hypothermia

Introduction of Ultra-High-Field MR Imaging in Infants: Preparations and Feasibility

Prevention of hypothermia in newborn submitted to surgical procedures: an integrative review

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