Pulmonary atelectasis in children anesthetized for cardiothoracic MR: Evaluation of risk factors

Netta M. Blitman, Hwayoung K. Lee, Vineet R. Jain, Alfin G. Vicencio, Michael Girshin, Linda B. Haramati

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

PURPOSE: To systematically assess the frequency and risk factors for atelectasis in children anesthetized for cardiothoracic magnetic resonance (MR). MATERIALS AND METHODS: We retrospectively identified 58 consecutive children (age range, 6 days to 21 years) who underwent cardiothoracic MR from January 2001 to December 2004 whose imaging and medical charts were available. One certificate of added qualification pediatric radiologist and 1 of 2 cardiothoracic radiologists, in consensus, evaluated the first and last set of axial images. Images were evaluated for cardiac, vascular and tracheobronchial abnormalities, and degree of atelectasis. Atelectasis was considered significant if the equivalent of 3 or more segments were involved. Patients received 1 or more of 7 anesthetic medications (n = 27), chloral hydrate alone (n = 4), or required no anesthesia (n = 27). RESULTS: Significant atelectasis developed only in those receiving anesthetic medications. Thirty-seven percent (10/27) of anesthetized children developed significant atelectasis in the first and/or last axial sequence. In 90% (9 /10) of patients, it developed in the first axial sequence. Strong risk factors were age younger than 1 year (80%, 8/10, P = 0.029) and MR evidence of tracheobronchial narrowing (50%, 5/10, P = 0.008). In patients with vascular ring, there was a trend toward significance (40%, 4/10, P = 0.09). None of the anesthesia factors were significant, including ventilation mode, anesthesia duration, or American Society of Anesthesiology risk (all P > 0.1). CONCLUSIONS: Atelectasis may occur shortly after induction of anesthesia in children younger than 1 year of age or with tracheobronchial narrowing when anesthetized for cardiothoracic MR.

Original languageEnglish (US)
Pages (from-to)789-794
Number of pages6
JournalJournal of Computer Assisted Tomography
Volume31
Issue number5
DOIs
StatePublished - Sep 2007

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Pulmonary Atelectasis
Magnetic Resonance Spectroscopy
Anesthesia
Blood Vessels
Anesthetics
Chloral Hydrate
Anesthesiology
Diagnostic Imaging
Ventilation
Pediatrics

Keywords

  • Magnetic resonance imaging
  • Pediatric
  • Sedation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Pulmonary atelectasis in children anesthetized for cardiothoracic MR : Evaluation of risk factors. / Blitman, Netta M.; Lee, Hwayoung K.; Jain, Vineet R.; Vicencio, Alfin G.; Girshin, Michael; Haramati, Linda B.

In: Journal of Computer Assisted Tomography, Vol. 31, No. 5, 09.2007, p. 789-794.

Research output: Contribution to journalArticle

Blitman, Netta M. ; Lee, Hwayoung K. ; Jain, Vineet R. ; Vicencio, Alfin G. ; Girshin, Michael ; Haramati, Linda B. / Pulmonary atelectasis in children anesthetized for cardiothoracic MR : Evaluation of risk factors. In: Journal of Computer Assisted Tomography. 2007 ; Vol. 31, No. 5. pp. 789-794.
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abstract = "PURPOSE: To systematically assess the frequency and risk factors for atelectasis in children anesthetized for cardiothoracic magnetic resonance (MR). MATERIALS AND METHODS: We retrospectively identified 58 consecutive children (age range, 6 days to 21 years) who underwent cardiothoracic MR from January 2001 to December 2004 whose imaging and medical charts were available. One certificate of added qualification pediatric radiologist and 1 of 2 cardiothoracic radiologists, in consensus, evaluated the first and last set of axial images. Images were evaluated for cardiac, vascular and tracheobronchial abnormalities, and degree of atelectasis. Atelectasis was considered significant if the equivalent of 3 or more segments were involved. Patients received 1 or more of 7 anesthetic medications (n = 27), chloral hydrate alone (n = 4), or required no anesthesia (n = 27). RESULTS: Significant atelectasis developed only in those receiving anesthetic medications. Thirty-seven percent (10/27) of anesthetized children developed significant atelectasis in the first and/or last axial sequence. In 90{\%} (9 /10) of patients, it developed in the first axial sequence. Strong risk factors were age younger than 1 year (80{\%}, 8/10, P = 0.029) and MR evidence of tracheobronchial narrowing (50{\%}, 5/10, P = 0.008). In patients with vascular ring, there was a trend toward significance (40{\%}, 4/10, P = 0.09). None of the anesthesia factors were significant, including ventilation mode, anesthesia duration, or American Society of Anesthesiology risk (all P > 0.1). CONCLUSIONS: Atelectasis may occur shortly after induction of anesthesia in children younger than 1 year of age or with tracheobronchial narrowing when anesthetized for cardiothoracic MR.",
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T1 - Pulmonary atelectasis in children anesthetized for cardiothoracic MR

T2 - Evaluation of risk factors

AU - Blitman, Netta M.

AU - Lee, Hwayoung K.

AU - Jain, Vineet R.

AU - Vicencio, Alfin G.

AU - Girshin, Michael

AU - Haramati, Linda B.

PY - 2007/9

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N2 - PURPOSE: To systematically assess the frequency and risk factors for atelectasis in children anesthetized for cardiothoracic magnetic resonance (MR). MATERIALS AND METHODS: We retrospectively identified 58 consecutive children (age range, 6 days to 21 years) who underwent cardiothoracic MR from January 2001 to December 2004 whose imaging and medical charts were available. One certificate of added qualification pediatric radiologist and 1 of 2 cardiothoracic radiologists, in consensus, evaluated the first and last set of axial images. Images were evaluated for cardiac, vascular and tracheobronchial abnormalities, and degree of atelectasis. Atelectasis was considered significant if the equivalent of 3 or more segments were involved. Patients received 1 or more of 7 anesthetic medications (n = 27), chloral hydrate alone (n = 4), or required no anesthesia (n = 27). RESULTS: Significant atelectasis developed only in those receiving anesthetic medications. Thirty-seven percent (10/27) of anesthetized children developed significant atelectasis in the first and/or last axial sequence. In 90% (9 /10) of patients, it developed in the first axial sequence. Strong risk factors were age younger than 1 year (80%, 8/10, P = 0.029) and MR evidence of tracheobronchial narrowing (50%, 5/10, P = 0.008). In patients with vascular ring, there was a trend toward significance (40%, 4/10, P = 0.09). None of the anesthesia factors were significant, including ventilation mode, anesthesia duration, or American Society of Anesthesiology risk (all P > 0.1). CONCLUSIONS: Atelectasis may occur shortly after induction of anesthesia in children younger than 1 year of age or with tracheobronchial narrowing when anesthetized for cardiothoracic MR.

AB - PURPOSE: To systematically assess the frequency and risk factors for atelectasis in children anesthetized for cardiothoracic magnetic resonance (MR). MATERIALS AND METHODS: We retrospectively identified 58 consecutive children (age range, 6 days to 21 years) who underwent cardiothoracic MR from January 2001 to December 2004 whose imaging and medical charts were available. One certificate of added qualification pediatric radiologist and 1 of 2 cardiothoracic radiologists, in consensus, evaluated the first and last set of axial images. Images were evaluated for cardiac, vascular and tracheobronchial abnormalities, and degree of atelectasis. Atelectasis was considered significant if the equivalent of 3 or more segments were involved. Patients received 1 or more of 7 anesthetic medications (n = 27), chloral hydrate alone (n = 4), or required no anesthesia (n = 27). RESULTS: Significant atelectasis developed only in those receiving anesthetic medications. Thirty-seven percent (10/27) of anesthetized children developed significant atelectasis in the first and/or last axial sequence. In 90% (9 /10) of patients, it developed in the first axial sequence. Strong risk factors were age younger than 1 year (80%, 8/10, P = 0.029) and MR evidence of tracheobronchial narrowing (50%, 5/10, P = 0.008). In patients with vascular ring, there was a trend toward significance (40%, 4/10, P = 0.09). None of the anesthesia factors were significant, including ventilation mode, anesthesia duration, or American Society of Anesthesiology risk (all P > 0.1). CONCLUSIONS: Atelectasis may occur shortly after induction of anesthesia in children younger than 1 year of age or with tracheobronchial narrowing when anesthetized for cardiothoracic MR.

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KW - Pediatric

KW - Sedation

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