MRI in Neonates

[drprasadrao]

Hello!! greetings from Hyderabad India
what sedation or anaesthesia do you use in neonates for procedures like MRI.

[Stefan Johansson]

Chloral hydrate (25-50 mg/kg)

[rehman_naveed]

Short anasthesia, Chloral hydrate for CT scan, not for MRI

[slegna01]

Hello!! greetings from Hyderabad India
what sedation or anaesthesia do you use in neonates for procedures like MRI.

Hello from Austin, Texas. Until recently we were using chloralhydrate. The babies had to be npo and have IV's started. We recently trialed a product that has allowed us to do MRI's without any sedation at all. We have had a 94% success rate without using any sedation. As a nurse who must take infant's for their scans this has been a miracle device as far as we're concerned. The company is CFI Medical Solutons, the product is MedVac Vacuum immobilizaton Bag, Infant splint. Part number: VMR33PUBB.

The web address is: www.contourfab.com

Debra Boyd:)

[wackdi]

Hello!

We are breastfeeding/feeding them (shortly before the examination) for a CT-Scans and Chloralhydrate for MRI-Scans.

Debra:
How do the infants tolerate the bag you have described? Do you feed them before examination? How often do you have to stop the exam because of a crying baby? What do the parents say about it?

I know: Many questions ... but I would be deeply grateful to get a short answer.

Greetings from Sweden

Dirk

[Stefan Johansson]

We are breastfeeding/feeding them (shortly before the examination) for a CT-Scans and Chloralhydrate for MRI-Scans.
...

Sorry about my short previous response. This is also how we do it! :)

[slegna01]

We feed the baby before the MRI.

While the product is described as a "bag", it's really not. I'll try to describe it. It's really a plastic rectangular pad. At the level of the shoulders it cuts in so the face isn't covered when you wrap the baby in it. The pad feels like it has mini styrofoam balls in it. There are straps that hold it around the baby. The really neat thing about it is that after you secure the infant in it, you atatch a vacuum to a port on the pad and "suck the air " out of it. It contains the infant without compressing him. The baby looks like a little papoose. I tried it on my arm when we first got it because I was concerned that it was "squishing" the baby. I couldn't even get it to constrict on my arm.

The babies seem to tolerate it well. We have used it on ventilated patients without problems. The babies also stay warm. We had problems with the babies getting very cold during the procedure. We also are not having to deal with the side effects of the sedation. We have had to delay discharges because an infant has had an apneic spell when sedated.

I can't give any real numbers on how many interruptions we've had due to crying babies. I've only had one "failed" study and it was successfully repeated the next day. We seem to have the biggest problems with our extreme micropremies who are now 3-4 months old and don't like the confinement. I did one tonight and did have to take her out 3 times but we finished it . This was the exception to the rule. Usually we are able to do it with no interruptions.

I'm not aware of any concerns from the parents but I'm also not sure how familiar they are with the procedure itself. I think the parents find it reassuring that there is no need for sedation.

I took the original web addess from my address bar but have found another on the product.

www.cfimedicaL.com
Product ID: VMR433X01 1 8036

Sorry for the dissertation. Hope it is helpful. I do think this has been one of the most impressive products I have seen (and I'm not a company rep).

Debra

[wackdi]

Thank you so much for your detailed answer!
This helps a lot to get an impression from a practitioner (And not from a salesman ;-) )!

Greetings Dirk

[mathur_a]

Please see our manuscript describing the process. Mathur A et al 2008. The Medvac bag costs around $800 USD and lasts about 2 years but is definitely worth the price.
Amit

[kotsi]

we do not use any sedation. We use sucrose pacifier if needed

[gayle omansky]

Hello! We also do not use any sedation for MRI or CT scan, we also make sure they are fed shortly before the procedure and we do not have to repeat imaging. We swaddle and use a pacifier and have success. The papoose bag does sound interesting though!
Regards, Gayle

[JACK]

Nice info

LINK 1 (http://www.cfimedical.com/downloads/Transporting,%20Stabilizing%20and%20Performing%20B rain%20MRI%20in%20Neonates%20Without%20Sedation.pd f)

LINK 2 (http://www.cfimedical.com/downloads/Medvac%20Instructional%20Presentation.pps)

[susanyoung]

We have the MedVac vest also and find that it helps the infants feel snug and secure. We apply a hat and MiniMuffs, remove t-shirts if worn, wrap in a blanket, then the vest. It provides full body support and works well with a varying size infants. The babies stay quiet. When possible, we feed prior to the procedure, and bring sucrose as a back-up.

[bisht02]

a nice way to immobilise for MRI without using sedation. As we have experienced seious apnoeas after cloral hydrate and morphine.

[drpanditji]

Keep baby NBM for 2 hours prior to procedure. Give choloral hydrate 30 min before procedure. Almost 100% success rate following this regime for MRI