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Erschienen in: Pediatric Radiology 8/2016

30.03.2016 | Original Article

A quality improvement project to reduce hypothermia in infants undergoing MRI scanning

verfasst von: Priti G. Dalal, Janelle Porath, Uma Parekh, Padmani Dhar, Ming Wang, Michael Hulse, Dennis Mujsce, Patrick M. McQuillan

Erschienen in: Pediatric Radiology | Ausgabe 8/2016

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Abstract

Background

Hypothermia prevention strategies during MRI scanning under general anesthesia in infants may pose a challenge due to the MRI scanner’s technical constraints. Previous studies have demonstrated conflicting results related to increase or decrease in post-scan temperatures in children. We noted occurrences of post-scan hypothermia in anesthetized infants despite the use of routine passive warming techniques.

Objective

The aims of our quality improvement project were (a) to identify variables associated with post-scan hypothermia in infants and (b) to develop and implement processes to reduce occurrence of hypothermia in neonatal intensive care unit (NICU) infants undergoing MRI.

Materials and methods

One hundred sixty-four infants undergoing MRI scanning were prospectively audited for post-scan body temperatures. A multidisciplinary team identified potential variables associated with post-scan hypothermia and designed preventative strategies: protocol development, risk factor identification, vigilance and use of a vacuum immobilizer. Another audit was performed, specifically focusing on NICU infants.

Results

In the initial phase, we found that younger age (P = 0.002), lower weight (P = 0.005), lower pre-scan temperature (P < 0.01), primary anesthetic technique with propofol (P < 0.01), advanced airway devices (P = 0.02) and being in the NICU (P < 0.01) were associated with higher odds for developing post-scan decrease in body temperature. Quality improvement processes decreased the occurrence of hypothermia in NICU infants undergoing MRI scanning from 65% to 18% (95% confidence interval for the difference, 26-70%, P < 0.001).

Conclusion

Several variables, including being in the NICU, are associated with a decrease in post-scan temperature in infants undergoing MRI scanning under sedation/general anesthesia. Implementation of strategies to prevent hypothermia in infants may be challenging in the high-risk MRI environment. We were able to minimize this problem in clinical practice by applying quality improvement principles.
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Metadaten
Titel
A quality improvement project to reduce hypothermia in infants undergoing MRI scanning
verfasst von
Priti G. Dalal
Janelle Porath
Uma Parekh
Padmani Dhar
Ming Wang
Michael Hulse
Dennis Mujsce
Patrick M. McQuillan
Publikationsdatum
30.03.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Pediatric Radiology / Ausgabe 8/2016
Print ISSN: 0301-0449
Elektronische ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-016-3592-0

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