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[Mechanical ventilation during MRI in children. Anesthetic constraints]
S Sifeddine1, R Badaoui, N Hassi
1CHG de Compiègne, Département d'Anesthésie-Réanimation.
Abstract:
Early use of magnetic resonance imaging (MRI) excluded patients needing mechanical ventilation. However magnetic resonance imaging is an innocuous investigation and affords important elements to the diagnosis of many pathologies. Improvement of anaesthetic equipment have led to enlarge MRI applications considerably. Ventilations situated outside the MRI room required very long tubing, to 9-11 m. Although the ferromagnetic charge of presently used ventilators is greatly reduced, it is still necessary to keep them at some distance from the patient, with tubing of about 3 m, even in children. Therefore the compressible gas volumes are larger than the usual ones. For a tube length of 3 m, about 2-3 ml.kg-1 should be added to the standard tidal volume (10 ml.kg-1), so as to obtain safe normoventilation.
Insights
Mechanical ventilation is now safer during magnetic resonance imaging (MRI) procedures. Adjusting tidal volume for longer tubing ensures safe patient ventilation in the MRI environment.
Area of Science:
- Medical Imaging
- Anesthesiology
- Respiratory Care
Context:
- Magnetic resonance imaging (MRI) was initially limited for patients requiring mechanical ventilation.
- Advancements in anesthetic equipment have expanded MRI applications.
- Long tubing (3m) for ventilators outside the MRI room increases compressible gas volumes.
Purpose:
- To address the challenges of mechanical ventilation during MRI.
- To ensure safe and effective patient ventilation in the MRI environment.
Summary:
- Early MRI protocols excluded ventilated patients due to safety concerns.
- Improved anesthetic equipment and ventilator design allow for closer patient proximity.
- Increased tubing length necessitates adjusting tidal volume to maintain normoventilation.
Impact:
- Enables broader application of MRI for critically ill patients.
- Improves diagnostic capabilities for pathologies requiring ventilation.
- Enhances patient safety during MRI procedures.