Track topics on Twitter Track topics that are important to you
The number of children undergoing MRI imaging has increased significantly in the past years, because many young children cannot stay still for the duration of the scan, have difficulty tolerating the confined space and the noise produced by the Magnetic Resonance Imaging (MRI) machine, sedation or General Anesthesia is required in these cases. In the investigators institution, the investigators use General Anesthesia for children undergoing MRI.
Because children have a larger surface area to body weight ratio; hypothermia from passive heat loss is one of the anesthesiologists' concerns.
MRI requires a cool environment with low humidity; this specialized environment represents a significant thermal challenge to the anesthetized children. Since most temperature devices are not compatible with the MRI, the simple task to measure temperature change has never been investigated.
It is known that following the induction of anesthesia, core hypothermia occurs in three stages;
2. Linear phase
3. Plateau phase Redistribution This accounts for the largest drop in core temperature of the three stages. Vasodilatation causes redistribution of heat from the core to the periphery.
Linear Phase This begins at the start of surgery as the patient is exposed to cold cleaning fluids and cool air flow in the theatre. Heat loss exceeds heat production, and most surgery does not extend past the linear phase.
- Radiation contributes the most (40%) and is proportional to environment/core, temperature difference to the power of four.
- Convection contributes up to 30% and is proportional to air velocity.
- Conduction contributes up to 5% and is proportional to the difference in surface temperatures.
- Evaporation contributes up to 15% and occurs from cleaning fluids, skin, respiratory and wound. A laparotomy can contribute up to 50% of the total.
- Respiratory contributes 10% (8% evaporation of water; 2% heating of air) and is enhanced by the cooling effect of cold anesthetic gases.
- Cold intravenous fluids. Plateau Phase Once core temperature falls below the thermoregulatory threshold, peripheral vasoconstriction increases and acts to limit the heat loss from the core department. When core heat production = heat loss to the peripheral compartment, core temperature reaches a plateau. Patients with an autonomic neuropathy (diabetics) have impaired sympathetic vasoconstriction and are unable to establish a core plateau in phase 3. Combined general and regional anesthesia will have a similar effect as the regional anesthetic (spinal/epidural) will prevent vasoconstriction in the legs; i.e. failure to establish a core plateau.
The ability to maintain body temperature is also compromised because anesthesia impairs intrinsic thermoregulatory response.
Heating devices including fluid warmers and bear huggers, commonly used in the Operating Room theaters, are incompatible with MRI.
On the other hand, MRI produces Radiofrequency Energy that transforms into heat within the patient's tissues. This may partially offset the heat loss.
The purpose of our study is to determine if children undergoing MRI under General Anesthesia become hypothermic and whether aggressive measures should be taken to prevent passive heat loss during MRI studies.
Study Design This is an observational, prospective non blinded study.
Observational Model: Case-Only, Time Perspective: Prospective
Children Requiring MRI
University of Medicine and Dentistry New Jersey
Published on BioPortfolio: 2014-07-23T21:09:17-0400
The objective of this study is to assess the safety and clinical utility of DuragesicÂ® 12.5 micrograms/hour (a transdermal patch delivering the narcotic pain-reliever fentanyl) in the t...
Hand and feet lacerations are common in children with repair often requiring conscious sedation and needle sticks for repair. Growing evidence in adults reveal that many of these small lac...
The purpose of this study is to assess the effectiveness and safety of DurogesicÂ® (a transdermal patch delivering the narcotic pain-reliever fentanyl) in the treatment of children with ...
Sodium nitroprusside (SNP) has been approved for control of blood pressure in adults, yet there are no controlled studies in children. The purpose of this study is to determine the effica...
Acute appendicitis (AA) is the most common condition requiring emergency surgery in children. At a network of institutions nationwide, a tool called the pediatric appendicitis risk calcula...
Inadequate treatment of painful conditions in children is a significant and complex problem. The objective of this study was to examine the effect of socioeconomic status on the provision of analgesic...
This review examines the current literature and provides insight into the role of food immunotherapy in the management of food-allergic children. Key food immunotherapy trials, benefits, and risks of ...
Children with obesity are more likely to suffer gastroesophageal reflux disease, requiring acid-suppression therapy with proton pump inhibitors (PPIs) and no guidelines regarding dosing.
A platform requiring multidimensional trunk movement facilitated postural balance in children with cerebral palsy.
Vision screening can identify people who have vision problems requiring a comprehensive examination. When children are screened, the most prevalent serious problem is amblyopia secondary to uncorrecte...
Children who have reached maturity or the legal age of majority.
Children with mental or physical disabilities that interfere with usual activities of daily living and that may require accommodation or intervention.
Financial assistance provided by the government to indigent families with dependent children who meet certain requirements as defined by the Social Security Act, Title IV, in the U.S.
Situations or conditions requiring immediate intervention to avoid serious adverse results.
The smallest species of TAPEWORMS. It is the only cestode that parasitizes humans without requiring an intermediate host.
Pediatrics is the general medicine of childhood. Because of the developmental processes (psychological and physical) of childhood, the involvement of parents, and the social management of conditions at home and at school, pediatrics is a specialty. With ...
Radiology is the branch of medicine that studies imaging of the body; X-ray (basic, angiography, barium swallows), ultrasound, MRI, CT and PET. These imaging techniques can be used to diagnose, but also to treat a range of conditions, by allowing visuali...
Anesthesia is the loss of feeling or sensation in all or part of the body. It may result from damage to nerves or can be induced by an anesthetist (a medical professional) using anesthetics such as thiopental or propofol or sevoflurane during a surgical ...