Cardiac magnetic resonance imaging can be performed without the use of anesthesia in patients 7-10 years of age with child life support and MRI video goggles
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KeywordsCongenital Heart Disease Cardiac Magnetic Resonance Cardiac Magnetic Resonance Imaging Categorical Analysis Educational Tool
Cardiac magnetic resonance imaging (CMR) is utilized as both a primary and adjunctive imaging modality for the diagnosis and evaluation of congenital heart disease, cardiomyopathy and characterization of myocardial iron loading. Adequate image quality and accurate diagnosis is dependent on the patient lying still; however, CMR exams can be long, requiring children to lie still for periods of time up to 1.5hours. In order to limit motion in children, anesthesia services are often required; and prior to August 2012 our institution did not offer awake CMR prior to 10 years of age unless extenuating circumstances exist. After August 2012, our CMR team instituted a change in policy to attempt CMR without anesthesia in patients less than 10 years of age if the educational tools utilized by child life were successful.
The aim of this study was to determine whether our institution can decrease anesthesia utilization, safely, for CMR in children age 7-10 years of age while using child life specialists prior to CMR and video goggles during CMR.
This retrospective, cohort study included patients 7-10 years of age undergoing CMR imaging over two periods of time, August 2010-August 2012 (Era 1) and August 2013-August 2015 (Era 2). Era 1 was prior to an institutional policy change to attempt CMR exams without anesthesia in subjects less than 10 years of age. Era 2 had CMR exams performed following implementation of a program to perform CMR without anesthesia in the same age range. Child life specialists and video goggles were being employed in our Radiology department throughout both eras. However, the goal during Era 2 was to assess the suitability of attempting a CMR exam awake, in patients scheduled for CMR under anesthesia. Categorical analysis was used to determine differences between Eras.
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