Department of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168, Rome, Italy.
BMC Anesthesiol. 2022 Sep 2;22(1):279. doi: 10.1186/s12871-022-01821-3.
Pediatric anesthesia care in the Magnetic Resonance Imaging is a challenge for clinicians. The recent debate about the role of anesthetic agent on neural development, encouraged an evaluation of their actual activity in this environment. In this active call survey, the authors sought to delineate the Italian situation regarding national centers, staff involved, monitoring tools available and sedation techniques.
A complete sample of all national centers performing almost a pediatric discharge in the 2014 was obtained from Health Ministry registers. All Institutions were contacted for a prospective phone investigation and a three-section survey was fill out with the Physician in charge. A descriptive and exploratory analyzes about the organization setting of the Centers were performed.
Among 876 Institution screened, only 106 (37%) met minimal criteria for inclusion. Children are managed by anesthesiologists in the 95% of cases, while neonates in the 54%. A dedicated nurse is present in 74% of centers. While a pulse oximetry is present in 100% of centers, the rate of prevalence of other monitoring is lower. A specific MRI-compatible ventilator is available in the 95% of Centers, but many tools are not equally homogenously distributed. Pharmacological approach is preferred in pediatric age (98%), but its use for newborns is reduced to 43%.
We found significant heterogeneity in the daily clinical practice of sedation in MRI. Our results could be a starting point to evaluate the further evolution of approach to children and neonates in magnetic resonance setting.
ClinicalTrials.gov identifier: NCT04775641.
儿科麻醉在磁共振成像中是临床医生面临的一个挑战。近期关于麻醉药物对神经发育作用的争论，促使人们对其在该环境中的实际作用进行评估。在这项主动呼叫调查中，作者试图描绘意大利全国中心的情况，包括涉及的人员、可用的监测工具和镇静技术。
从卫生部登记处获得了 2014 年几乎所有进行儿科出院的全国中心的完整样本。所有机构都被联系进行前瞻性电话调查，并由主治医生填写了三部分的调查。对中心的组织设置进行了描述性和探索性分析。
在筛选的 876 个机构中，只有 106 个（37%）符合纳入的最低标准。95%的情况下由麻醉师管理儿童，54%的情况下管理新生儿。74%的中心有专门的护士。虽然 100%的中心都有脉搏血氧仪，但其他监测工具的普及率较低。95%的中心都有专门的磁共振兼容呼吸机，但许多工具的分布并不均匀。在儿科年龄（98%）中首选药物镇静，但在新生儿中减少到 43%。
我们发现磁共振镇静的日常临床实践存在显著的异质性。我们的结果可以作为评估儿童和新生儿在磁共振环境中进一步发展的方法的起点。
ClinicalTrials.gov 标识符：NCT04775641。
