Cardiovascular MRI without sedation or general anesthesia using a feed-and-sleep technique in neonates and infants

Abstract

Background

MRI in small children generally necessitates the use of general anesthesia.

Objective

We describe our initial results with a new technique that we name the feed-and-sleep method, whereby an infant can undergo a cardiac MRI without the need for general anesthesia or sedation.

Materials and methods

The infant is fasted for 4 h prior to the scan and is then fed by his mother prior to the scan. He is then swaddled with 1 to 2 infant sheets before being placed in a vacuum-bag immobilizer. As air is removed from the bag, the immobilizer becomes a rigid cradle that fits the infant’s body. We prioritize the sequences according to the purpose of the study and in the order of clinical importance.

Results

Between January 2010 and January 2011 a total of 20 infants with the median age 14.5 days (minimum 2 days, maximum 155 days) underwent CMR studies via this method. All were performed successfully with no distress to the infant. The median scan time was 46.5 min (minimum 20, maximum 66). All had complex congenital heart defects and all planned sequences were acquired with sufficient quality to allow accurate diagnosis and to plan appropriate surgery.

Conclusion

Using this technique, infants younger than 6 months can complete a cardiovascular MRI without the need for sedation or general anesthesia. We advocate the incorporation of this safe and reliable technique into routine clinical practice.