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A prospective observational study to evaluate the magnitude of temperature changes in children undergoing elective
Merlin S Ruth1, Nivetha Sridharan2, Ekta Rai1
1Department of Anaesthesia, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.
Insights
Pediatric patients undergoing anesthesia for MRI scans experience a significant drop in core body temperature. Temperature decrease is linked to scan duration, not age or MRI scanner type, necessitating temperature preservation strategies.
Area of Science:
- Anesthesiology
- Pediatric Imaging
- Medical Physics
Background:
- Anesthesia and low ambient temperatures in MRI suites can cause pediatric patients to lose core body heat.
- Previous research on core temperature changes during pediatric MRI has yielded conflicting results.
Purpose of the Study:
- To determine whether hypothermia or hyperthermia predominates in children anesthetized for MRI.
- To assess if temperature changes vary by age group or MRI scanner type.
Main Methods:
- Prospective, observational study conducted at a tertiary care teaching hospital.
- 250 children (1 month to 16 years) undergoing MRI under propofol-based total intravenous anesthesia (TIVA) were enrolled.
- Core temperature was measured nasopharyngeally before anesthesia induction and after the scan in recovery.
Main Results:
- A significant core temperature decrease of 1.022°C was observed post-MRI (P < 0.001).
- No significant differences in temperature change were found across age groups or MRI scanner types.
- A significant correlation exists between MRI duration and temperature decrease (P = 0.003); each minute increases temperature loss by 0.006°C.
Conclusions:
- Maintaining vigilant temperature preservation strategies is crucial for anesthetized children in MRI suites.
- MRI-compatible active warming devices are recommended, particularly in high-volume centers.
Context:
Induction of general anesthesia and mandatory low-ambient temperature in the magnetic resonance imaging (MRI) suite renders the pediatric patient prone to fall in core temperature. Previously done studies have shown mixed results with core temperature showing both rise and fall.
Aims:
The aim of this study is to evaluate which effect, hypothermia or hyperthermia, predominates in children anesthetized for MRI. Is the change in temperature the same across age groups and for different MRI scanners?.
Settings And Design:
Prospective, observational study in a tertiary care teaching hospital.
Subjects And Methods:
Two hundred and fifty children of age between 1 month and 16 years scheduled for MRI under propofol-based total intravenous anesthesia (TIVA) were recruited. A baseline core temperature (pre-scan) was recorded with the pediatric nasopharyngeal temperature probe after induction of anesthesia and also after the scan in the recovery room.
Results:
The study shows that there is a significant fall in temperature of 1.022°C (CI = 0.964, 1.081) following MRI (P < 0.001) but the difference across different age groups and type of MRI scanner used are not significant. There is a significant correlation between duration in the MRI room and a decrease in temperature (P value = 0.003). Using simple linear regression analysis, it is found that if there is a 1-min increase in the duration of MRI, there is a decrease of 0.006°C in temperature.
Conclusion:
Vigilant temperature preservation strategies have to be maintained during the time the anesthetized child is present in the MRI suite. MRI compatible active warming devices are warranted especially in high turnover centers.
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