scholarly journals Factors Associated with Occurrence of Atelectasis during Sedation for Imaging in Pediatric Patients: A Retrospective Single Center Cohort Study

2021 ◽  
Vol 10 (16) ◽  
pp. 3598
Author(s):  
Pyeong Hwa Kim ◽  
Yong-Seok Park ◽  
Hee-Mang Yoon ◽  
Ah Young Jung ◽  
Eun-Young Joo ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Multivariable Analysis ◽  
Supplemental Oxygen ◽  
Whole Body ◽  
Factors Associated ◽  
Thoracic Level ◽  
Oxygen Administration ◽  
Body Magnetic Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Short Tau Inversion Recovery

Sedation can induce atelectasis which may cause suboptimal image quality. This study aimed to identify factors associated with the occurrence of atelectasis during sedation for imaging in pediatric patients. Patients < 18 years who had undergone whole-body magnetic resonance imaging (MRI) under sedation with propofol or dexmedetomidine were included in this study. The development of atelectasis was visually and quantitatively assessed by coronal short tau inversion recovery images of the thoracic level. Multivariable logistic regression was performed to identify the independent factors associated with the development of atelectasis. Ninety-one patients were included in the analysis. In the multivariable analysis, administration of supplemental oxygen was the only factor significantly associated with the occurrence of atelectasis (adjusted odds ratio, 4.84; 95% confidence interval, 1.48–15.83; p = 0.009). Univariable analysis showed that the use of dexmedetomidine was associated with a lower incidence of atelectasis; however, this could not be verified in the multivariable analysis. Among the pediatric patients who had undergone imaging under sedation, additional oxygen supplementation was the only independent factor associated with atelectasis occurrence. A prospective clinical trial is required to identify the cause-effect relationship between oxygen administration and occurrence of atelectasis during sedation.

scholarly journals Premedication with intranasal dexmedetomidine decreases barbiturate requirement in pediatric patients sedated for magnetic resonance imaging: a retrospective study

2018 ◽  
Author(s):  
Panu Uusalo ◽  
Mirjam Lehtinen ◽  
Eliisa Löyttyniemi ◽  
Tuula Manner ◽  
Mika Scheinin ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Oxygen Saturation ◽  
Pediatric Patients ◽  
Supplemental Oxygen ◽  
Procedural Sedation ◽  
Resonance Imaging ◽  
Peripheral Oxygen Saturation ◽  
Adrenoceptor Agonist ◽  
Magnetic Resonance Imaging Mri

Abstract Background: Barbiturates are commonly used in ambulatory sedation of pediatric patients. However, use of barbiturates involve risks of respiratory complications. Dexmedetomidine, a highly selective α2-adrenoceptor agonist, is increasingly used for pediatric sedation. Premedication with intranasal (IN) dexmedetomidine offers a non-invasive and efficient possibility to sedate pediatric patients undergoing magnetic resonance imaging (MRI). Our hypothesis was that dexmedetomidine would reduce barbiturate requirements in procedural sedation. Methods: We included 200 consecutive pediatric patients undergoing MRI, and analyzed their hospital records retrospectively. Half of the patients received 3 μg/kg of IN dexmedetomidine (DEX group) 45-60 min before MRI while the rest received only thiopental (THIO group) for procedural sedation. Sedation was maintained with further intravenous thiopental dosing as needed. Thiopental consumption, heart rate (HR) and peripheral oxygen saturation were recorded. Results: The cumulative thiopental requirement during MRI was (median and interquartile range [IQR]) 4.4 (2.7-6.0) mg/kg/h in the DEX group and 12.4 (9.8-14.8) mg/kg/h in the THIO group (difference 7.9 mg/kg/h, 95% CI 6.8–8.8, P < 0.001). Lowest measured peripheral oxygen saturation remained slightly higher in the DEX group compared to the THIO group (median nadirs and IQR: 97 (95-97) % and 96 (94-97) %, P < 0.001). Supplemental oxygen was delivered to 33 % of the patients in the THIO group compared to 2 % in the DEX group (P < 0.001). The lowest measured HR (mean and SD) was lower (78 (16) bpm) in the DEX group compared to the THIO group (92 (12) bpm) (P < 0.001). Conclusion: Premedication with IN dexmedetomidine (3 μg/kg) was associated with markedly reduced thiopental dosage needed for efficient procedural sedation for pediatric MRI.

scholarly journals Premedication with intranasal dexmedetomidine decreases barbiturate requirement in pediatric patients sedated for magnetic resonance imaging: a retrospective study

2018 ◽  
Author(s):  
Panu Uusalo ◽  
Mirjam Lehtinen ◽  
Eliisa Löyttyniemi ◽  
Tuula Manner ◽  
Mika Scheinin ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Oxygen Saturation ◽  
Pediatric Patients ◽  
Supplemental Oxygen ◽  
Procedural Sedation ◽  
Resonance Imaging ◽  
Peripheral Oxygen Saturation ◽  
Adrenoceptor Agonist ◽  
Magnetic Resonance Imaging Mri

Abstract Background: Barbiturates are commonly used in ambulatory sedation of pediatric patients. However, use of barbiturates involve risks of respiratory complications. Dexmedetomidine, a highly selective α2-adrenoceptor agonist, is increasingly used for pediatric sedation. Premedication with intranasal (IN) dexmedetomidine offers a non-invasive and efficient possibility to sedate pediatric patients undergoing magnetic resonance imaging (MRI). Our hypothesis was that dexmedetomidine would reduce barbiturate requirements in procedural sedation. Methods: We included 200 consecutive pediatric patients undergoing MRI, and analyzed their hospital records retrospectively. Half of the patients received 3 μg/kg of IN dexmedetomidine (DEX group) 45-60 min before MRI while the rest received only thiopental (THIO group) for procedural sedation. Sedation was maintained with further intravenous thiopental dosing as needed. Thiopental consumption, heart rate (HR) and peripheral oxygen saturation were recorded. Results: The cumulative thiopental requirement during MRI was (median and interquartile range [IQR]) 4.4 (2.7-6.0) mg/kg/h in the DEX group and 12.4 (9.8-14.8) mg/kg/h in the THIO group (difference 7.9 mg/kg/h, 95% CI 6.8–8.8, P < 0.001). Lowest measured peripheral oxygen saturation remained slightly higher in the DEX group compared to the THIO group (median nadirs and IQR: 97 (95-97) % and 96 (94-97) %, P < 0.001). Supplemental oxygen was delivered to 33 % of the patients in the THIO group compared to 2 % in the DEX group (P < 0.001). The lowest measured HR (mean and SD) was lower (78 (16) bpm) in the DEX group compared to the THIO group (92 (12) bpm) (P < 0.001). Conclusion: Premedication with IN dexmedetomidine (3 μg/kg) was associated with markedly reduced thiopental dosage needed for efficient procedural sedation for pediatric MRI.

scholarly journals A Rapidly Enlarging Solitary Infantile Myofibroma

2020 ◽  
Vol 4 (6) ◽  
pp. 608-612
Author(s):  
Stephany Vittitow ◽  
Merrick Kozak ◽  
Reza Daughtery ◽  
Barrett Zlotoff
Keyword(s):  
Imaging Modality ◽  
Mesenchymal Cell ◽  
Whole Body ◽  
Infantile Myofibromatosis ◽  
Life Threatening ◽  
Body Magnetic Resonance Imaging ◽  
Line Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Effects Of Radiation ◽  
Infantile Myofibroma

Infantile myofibromatosis is a rare disorder of mesenchymal cell proliferation that can affect the skin, bone, muscle, and viscera. We present a case of a 6-week-old male with a rapidly enlarging congenital solitary infantile myofibroma. The differential for congenital tumors of the head and neck is broad, and thorough evaluation is required to rule out life-threatening malignancy. Currently, there is no first-line imaging modality of choice to assess for skeletal and/or visceral involvement in patients with infantile myofibromatosis. We recommend the use of whole-body magnetic resonance imaging (MRI), as it quickly provides detailed information regarding extent of disease and does not expose the patient to the harmful effects of radiation.  

scholarly journals Premedication with intranasal dexmedetomidine decreases barbiturate requirement in pediatric patients sedated for magnetic resonance imaging: a retrospective study

2019 ◽  
Author(s):  
Panu Uusalo ◽  
Mirjam Lehtinen ◽  
Eliisa Löyttyniemi ◽  
Tuula Manner ◽  
Mika Scheinin ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Oxygen Saturation ◽  
Pediatric Patients ◽  
Supplemental Oxygen ◽  
Procedural Sedation ◽  
Resonance Imaging ◽  
Peripheral Oxygen Saturation ◽  
Adrenoceptor Agonist ◽  
Magnetic Resonance Imaging Mri

Abstract Background: Barbiturates are commonly used in ambulatory sedation of pediatric patients. However, use of barbiturates involve risks of respiratory complications. Dexmedetomidine, a highly selective α2-adrenoceptor agonist, is increasingly used for pediatric sedation. Premedication with intranasal (IN) dexmedetomidine offers a non-invasive and efficient possibility to sedate pediatric patients undergoing magnetic resonance imaging (MRI). Our hypothesis was that dexmedetomidine would reduce barbiturate requirements in procedural sedation. Methods: We included 200 consecutive pediatric patients undergoing MRI, and analyzed their hospital records retrospectively. Half of the patients received 3 μg/kg of IN dexmedetomidine (DEX group) 45-60 min before MRI while the rest received only thiopental (THIO group) for procedural sedation. Sedation was maintained with further intravenous thiopental dosing as needed. Thiopental consumption, heart rate (HR) and peripheral oxygen saturation were recorded. Results: The cumulative thiopental requirement during MRI was (median and interquartile range [IQR]) 4.4 (2.7-6.0) mg/kg/h in the DEX group and 12.4 (9.8-14.8) mg/kg/h in the THIO group (difference 7.9 mg/kg/h, 95% CI 6.8–8.8, P < 0.001). Lowest measured peripheral oxygen saturation remained slightly higher in the DEX group compared to the THIO group (median nadirs and IQR: 97 (95-97) % and 96 (94-97) %, P < 0.001). Supplemental oxygen was delivered to 33 % of the patients in the THIO group compared to 2 % in the DEX group (P < 0.001). The lowest measured HR (mean and SD) was lower (78 (16) bpm) in the DEX group compared to the THIO group (92 (12) bpm) (P < 0.001). Conclusion: Premedication with IN dexmedetomidine (3 μg/kg) was associated with markedly reduced thiopental dosage needed for efficient procedural sedation for pediatric MRI.

scholarly journals Whole-body magnetic resonance imaging for the diagnosis of metastasis in children and adolescents: a systematic review and meta-analysis

2021 ◽  
Vol 54 (5) ◽  
pp. 329-335
Author(s):  
Simone Gianella Valduga ◽  
Gabriele Carra Forte ◽  
Ricardo Pessini Paganin ◽  
Diego Gomez Abreu ◽  
Tássia Machado Medeiros ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Children And Adolescents ◽  
Latin American ◽  
Pediatric Patients ◽  
Meta Analysis ◽  
Whole Body ◽  
Cochrane Central Register ◽  
Resonance Imaging ◽  
Body Magnetic Resonance Imaging

Abstract Whole-body magnetic resonance imaging (WB-MRI) is a noninvasive imaging method that can be used to diagnose and stage tumors, as well as to assess therapeutic responses in oncology. The objective of this meta-analysis was to evaluate the accuracy of WB-MRI for the diagnosis of metastases in pediatric patients. The following electronic databases were searched: Medline, Embase, Cochrane Central Register of Controlled Trials, Scientific Electronic Library Online, Latin-American and Caribbean Health Sciences Literature, Cumulative Index to Nursing and Allied Health Literature, Web of Science, and ClinicalTrials.gov. All of the selected studies included children and adolescents with histopathological confirmation of a primary tumor. Collectively, the studies included 118 patients ranging in age from 7 months to 19 years. The pooled sensitivity and specificity of WB-MRI were, respectively, 0.964 (95% CI: 0.944-0.978; I2 = 0%) and 0.902 (95% CI: 0.882-0.919; I2 = 98.4%), with an area under the curve (AUC) of 0.991. We found that WB-MRI had good accuracy for the diagnosis of metastases in pediatric patients and could therefore provide an alternative to complete the staging of tumors in such patients, being a safer option because it does not involve the use of ionizing radiation.

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