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Intervention helped children complete MRI without sedation
Preparation and support procedures dramatically increased the likelihood that young children with sickle cell disease completed MRI testing without sedation, according to study results.
Patients with sickle cell disease often undergo brain and liver MRIs to check for complications related to their disease.
MRI exams also require children to lie motionless for 30 to 60 minutes, which often presents challenges and makes it difficult to obtain proper images, according to researchers. Sedation is one potential solution, but it can place young patients at an increased risk for anesthesia-related complications, which ultimately could trigger a sickle cell-related adverse event, according to researchers.
St. Jude Children’s Research Hospital in Memphis, Tenn., established preparation and support procedures to improve its young patients’ ability to cope with MRI exams and avoid sedation.
The interventions educate patients and families on what to expect during an MRI.
The preparation and support procedure steps include a consultation with a certified child life specialist who shows pediatric patients a small model of an MRI machine and pictures of the MRI suite, and also lets them listen to recordings that help them prepare for the sounds they’ll hear while undergoing an MRI.
In a retrospective study, researchers offered preparation and support procedures to children with sickle cell disease who were scheduled to undergo MRI exams from September 2008 to November 2009. The researchers hoped to identify strategies to help children cope with and successfully complete MRI testing without the use of sedation/anesthesia.
Katherine R. Cejda, MS, a child life specialist in the child life program at St. Jude Children’s Research Hospital, and colleagues compared results of MRI exams on patients who received the preparation and support procedures (n=33) with results of exams performed on patients who did not receive preparation (n=38).
Sixty of the children underwent a brain MRI and 11 underwent a liver R2*MRI.
The median age of patients was 9.9 years old.
A certified child life specialist evaluated all children within 30 days of MRI testing.
Of the 33 patients who received preparation and support services, seven chose to listen to music during the MRI, 25 watched a movie and one listened to an audio book.
Thirty of the children (91%) who received preparation and support procedures completed an interpretable MRI exam, compared with 27 (71%) who did not receive preparation (unadjusted OR=4.1; P=.04 and OR=8.5; P<.01 when adjusted for age), according to researchers.
After adjusting for age, children who received preparation and support procedures were 8.5 times more likely to successfully complete an interpretable MRI exam than those who did not (95% CI, 1.7-43.3), study results showed.
“Our results show that the use of preparatory procedures along with supportive measures allowed young children with sickle cell disease to undergo MRI testing of the brain and liver, yielding clinically useful results while eliminating the risks associated with the use of sedation,” Cejda and colleagues wrote.
Prospective, randomized studies are necessary to confirm the results of the study, Cejda and colleagues concluded.
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Cejda KR. Pediatr Radiol. 2012;doi:10.1007/s00247-012-2422-2.