Pediatric Radiology

, Volume 44, Issue 2, pp 164–172 | Cite as

Chest CT in children: anesthesia and atelectasis

  • Beverley Newman
  • Elliot J. Krane
  • Rakhee Gawande
  • Tyson H. Holmes
  • Terry E. Robinson
Original Article

Abstract

Background

There has been an increasing tendency for anesthesiologists to be responsible for providing sedation or anesthesia during chest CT imaging in young children. Anesthesia-related atelectasis noted on chest CT imaging has proven to be a common and troublesome problem, affecting image quality and diagnostic sensitivity.

Objective

To evaluate the safety and effectiveness of a standardized anesthesia, lung recruitment, controlled-ventilation technique developed at our institution to prevent atelectasis for chest CT imaging in young children.

Materials and methods

Fifty-six chest CT scans were obtained in 42 children using a research-based intubation, lung recruitment and controlled-ventilation CT scanning protocol. These studies were compared with 70 non-protocolized chest CT scans under anesthesia taken from 18 of the same children, who were tested at different times, without the specific lung recruitment and controlled-ventilation technique. Two radiology readers scored all inspiratory chest CT scans for overall CT quality and atelectasis. Detailed cardiorespiratory parameters were evaluated at baseline, and during recruitment and inspiratory imaging on 21 controlled-ventilation cases and 8 control cases.

Results

Significant differences were noted between groups for both quality and atelectasis scores with optimal scoring demonstrated in the controlled-ventilation cases where 70% were rated very good to excellent quality scans compared with only 24% of non-protocol cases. There was no or minimal atelectasis in 48% of the controlled ventilation cases compared to 51% of non-protocol cases with segmental, multisegmental or lobar atelectasis present. No significant difference in cardiorespiratory parameters was found between controlled ventilation and other chest CT cases and no procedure-related adverse events occurred.

Conclusion

Controlled-ventilation infant CT scanning under general anesthesia, utilizing intubation and recruitment maneuvers followed by chest CT scans, appears to be a safe and effective method to obtain reliable and reproducible high-quality, motion-free chest CT images in children.

Keywords

Chest CT Infants Atelectasis Lung recruitment Controlled ventilation 

Notes

Acknowledgments

Source of funding: The project was supported by the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health, through UL1 RR025744, and by the Lucile Packard Foundation for Children's Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Conflicts of interest

None.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Beverley Newman
    • 1
  • Elliot J. Krane
    • 2
  • Rakhee Gawande
    • 1
  • Tyson H. Holmes
    • 3
  • Terry E. Robinson
    • 4
  1. 1.Department of RadiologyLucile Packard Children’s HospitalStanfordUSA
  2. 2.Department of Anesthesiology, Perioperative and Pain MedicineStanford University School of Medicine, Lucile Packard Children’s HospitalStanfordUSA
  3. 3.Department of Psychiatry and Behavioral SciencesStanford University School of Medicine, Lucile Packard Children’s HospitalStanfordUSA
  4. 4.Department of Pulmonary Medicine and Cystic Fibrosis Center for Excellence in Pulmonary BiologyStanford University School of Medicine, Lucile Packard Children’s HospitalStanfordUSA

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