Ureta-Velasco N, Martínez-de Aragón A, Moral-Pumarega M T, Núñez-Enamorado N, Bergón-Sendín E, Pallás-Alonso C R
Departamento de Pediatría, Servicio de Neonatología, Hospital Universitario 12 de Octubre, Madrid, España.
Servicio de Radiodiagnóstico, Neurorradiología Infantil, Hospital Universitario 12 de Octubre, Madrid, España.
An Pediatr (Barc). 2015 May;82(5):354-9. doi: 10.1016/j.anpedi.2014.05.019. Epub 2014 Jul 4.
The ability to perform magnetic resonance imaging (MRI) without sedation in the neonatal period increases patient safety, availability and profitability of the diagnostic tool. The aim in this study was to evaluate a new protocol of MRI without sedation during a 20-month period. In the protocol, the patients are prepared in the neonatal unit.
Prospective descriptive study, from May 2012 to December 2013. Patients included were neonates requiring MRI, clinically stable and not requiring ventilatory support. The method was based on the application of developmental centered care and the use of a vacuum matress to immobilize the baby. The principal outcome parameter of interest was the percentage of succesfully completed MRIs. The duration of the MRI and the number of interruptions, was also studied from October 2012.
A total of 43 MRIs without sedation were carried out on 42 patients: 41 cerebral and 2 spinal. The success rate was 97.7% (42/43). The mean MRI time was 26.3 minutes (95% CI 23.3-29.3 mins; range 16-50 mins). MRIs were completed without interruption in 20 of the 34 cases (58%) in which the duration was recorded. The number of interruptions per procedure varied from 0 to 3, with a mean of 0.6 (95% CI 0.3-0.8) and a median of 0.
The protocol had a success rate of over 90%. Thus MRI without sedation seems applicable in Spanish hospitals, with most of the preparation being performed in the neonatal unit, in order to reduce the occupation of the MRI unit, as well as minimizing stress to the baby.
新生儿期无需镇静即可进行磁共振成像（MRI）的能力提高了该诊断工具的患者安全性、可用性和收益性。本研究的目的是评估一项在20个月期间内无需镇静的MRI新方案。在该方案中，患者在新生儿病房进行准备。
前瞻性描述性研究，时间为2012年5月至2013年12月。纳入的患者为需要进行MRI检查、临床状况稳定且无需通气支持的新生儿。该方法基于以发育为中心的护理应用以及使用真空床垫固定婴儿。主要关注的结果参数是成功完成MRI检查的百分比。自2012年10月起，还对MRI的持续时间和中断次数进行了研究。
共对42例患者进行了43次无需镇静的MRI检查：41次脑部检查和2次脊髓检查。成功率为97.7%（42/43）。MRI的平均时间为26.3分钟（95%置信区间23.3 - 29.3分钟；范围16 - 50分钟）。在记录了持续时间的34例病例中，有20例（58%）的MRI检查未被中断完成。每次检查的中断次数从0到3不等，平均为0.6次（95%置信区间0.3 - 0.8），中位数为0次。
该方案的成功率超过90%。因此，无需镇静的MRI似乎适用于西班牙的医院，大部分准备工作在新生儿病房进行，以减少MRI设备的占用时间，并将对婴儿的压力降至最低。
