Utility of feed-and-sleep cardiovascular magnetic resonance in young infants with complex cardiovascular disease. 2015

Masoud Shariat, and Luc Mertens, and Mike Seed, and Lars Grosse-Wortmann, and Fraser Golding, and Laura Mercer-Rosa, and Matthew Harris, and Kevin K Whitehead, and Christine Li, and Mark A Fogel, and Shi-Joon Yoo
Department of Medical Imaging, University Health Network, University of Toronto, 585 University Ave., Toronto, ON, M5G 2N2, Canada, masoudshariat@gmail.com.

Utilization of cardiovascular magnetic resonance (CMR) is limited in young children because of the need for sedation or general anesthesia (GA). It has been previously shown that CMR can be performed without sedation or GA in young infants who are prone to fall asleep after being fed and swaddled. The purpose of this study was to prospectively prove the feasibility of the feed-and-sleep CMR technique in larger cohorts in the two institutions where the technique was initially developed. This was a prospective dual-center cohort study over a two-year period. All infants younger than 6 months old with complex congenital cardiovascular anomaly who required CMR were recruited for this study. The exclusion criteria included mechanical ventilation, oxygen dependence, feeding difficulties, and any contraindication to CMR. The feed-and-sleep study was performed by fasting the infant for a period of 4 h prior to the scan, placing the infant in a vacuum immobilizer, and feeding the infant just prior to the CMR. The CMR sequences were prioritized to target the area of most importance first. A study was considered complete and diagnostic if the clinical question was answered. A total of 60 infants (39 from center A and 21 from center B) were recruited for this study, 32 male and 28 female, ages ranging from 1 to 177 days (50 ± 54). The CMR studies were diagnostic and answered the clinical questions in all patients. All infants tolerated the procedure well, and no complications were noted in any of the patients. The CMR duration ranged between 4-132 minutes (45 ± 21). The feed-and-sleep approach in selected patients obviates the need of sedation or GA for CMR in infants younger than 6 months old. Therefore, CMR can be utilized whenever echocardiography fails to provide the complete information required for the patients' management.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007225 Infant Food Food processed and manufactured for the nutritional health of children in their first year of life. Food, Infant,Foods, Infant,Infant Foods
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D008297 Male Males
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D012149 Restraint, Physical Use of a device for the purpose of controlling movement of all or part of the body. Splinting and casting are FRACTURE FIXATION. Immobilization, Physical,Physical Restraint,Physical Immobilization,Physical Restraints,Restraints, Physical
D002318 Cardiovascular Diseases Pathological conditions involving the CARDIOVASCULAR SYSTEM including the HEART; the BLOOD VESSELS; or the PERICARDIUM. Adverse Cardiac Event,Cardiac Events,Major Adverse Cardiac Events,Adverse Cardiac Events,Cardiac Event,Cardiac Event, Adverse,Cardiac Events, Adverse,Cardiovascular Disease,Disease, Cardiovascular,Event, Cardiac
D005215 Fasting Abstaining from FOOD. Hunger Strike,Hunger Strikes,Strike, Hunger,Strikes, Hunger
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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