Haney Barbara, Reavey Daphne, Atchison Linda, Poull Janice, Dryer Lisa, Anderson Betsi, Sandritter Tracy, Pallotto Eugenia
Children's Mercy Hospitals and Clinics, Kansas City, Missouri 64108, USA.
J Perinat Neonatal Nurs. 2010 Jul-Sep;24(3):256-66. doi: 10.1097/JPN.0b013e3181e8d566.
Use of magnetic resonance imaging (MRI) in the neonatal intensive care unit has been increasing over the past several years because of improved MRI technology and increased clinical awareness of the prognostic and diagnostic information available. Historically, the use of sedation has been the standard for achieving quality imaging without motion artifact, but it exposed the patient to risks associated with sedation medications. In an effort to obtain MRI studies with elimination of risks associated with sedation, a quality improvement project was initiated. Implementing a standardized approach utilizing a vacuum immobilizer has led to successful neonatal MRI completion without the need for sedation in 94% of study attempts. Acceptable or excellent image quality was achieved in more than 97% of attempts. Time away from the neonatal intensive care unit significantly decreased with this approach, with the mean duration of time away decreasing from 60 to 48 minutes (P < .0001). Obtaining MRI studies without sedation can be successfully implemented in a neonatal intensive care unit, nearly eliminating patient risks associated with sedation while improving utilization of hospital resources and maintaining adequate quality imaging.
在过去几年中，由于磁共振成像（MRI）技术的改进以及临床对其可提供的预后和诊断信息的认识增加，新生儿重症监护病房中MRI的使用一直在增加。从历史上看，使用镇静剂一直是获得无运动伪影的高质量成像的标准方法，但这使患者面临与镇静药物相关的风险。为了在消除与镇静相关风险的情况下进行MRI检查，启动了一项质量改进项目。采用标准化方法使用真空固定器已使94%的研究尝试成功完成新生儿MRI检查，而无需使用镇静剂。超过97%的尝试获得了可接受或优异的图像质量。采用这种方法后，新生儿重症监护病房外的时间显著减少，平均离开时间从60分钟降至48分钟（P <.0001）。在新生儿重症监护病房中可以成功实施无需镇静的MRI检查，几乎消除了与镇静相关的患者风险，同时提高了医院资源的利用率并保持了足够的高质量成像。
