The Feed and Sleep method: how to perform a cardiac MRI in the 1st year of life without the need for General Anesthesia

Abstract

Introduction : MRI in small children as a general rule necessitates the use of general anesthesia. We describe our initial results with a new technique which we name the feed and sleep method whereby an infant can undergo a Cardiac MRI without the need for general anesthesia or sedation. Methods The infant is starved for 4 hours prior to the scan and is then fed by his mother prior to the scan. He is then swaddled with 1 to 2 infant sheets before placed within a vacuum-bag immobilizer. As air is removed from the bag, the immobilizer becomes a rigid cradle that fits the infant's body. We prioritize the sequences to target the area of importance first according to the purposes of the study and in the order of clinical importance. Results Between Jan and July 2010 a total of 12 infants median age 14 days (minimum 2 days maximum 150 days) have undergone CMR studies via this method. All were performed successfully with no distress to the infant.The average scan time was 45.5 min (minimum 24, maximum 65 min). All had complex congenital heart defects (Table 1) and all planned sequences were able to be acquired ensuring the scans were of sufficient quality to allow accurate diagnosis and to plan appropriate future surgery. Conclusion Using this technique infants under the age of 6 months can complete a cardiovascular MRI, without the need for general anesthesia. We advocate the incorporation of this safe and reliable technique into routine clinical practice. (Table Presented).