Abstract
Purpose: Respiratory adverse events are common during sedation of preterm babies, often needing an active airways support. During magnetic resonance imaging it could extend the acquisition time, with negative impact on the thermic and metabolic homeostasis. The aim of study is to verify if the lying in lateral position instead of supine could improve quality of sedation, without worsen quality of imaging
Methods. This study was performed as a single-center, prospective study at a university-affiliated tertiary care center. A consultant provided a deep sedation with sevoflurane 3-4% delivered by an external mask, in lateral lying. All patients were evaluated for incidence of apnea and desaturation, quality of imaging obtained, timing of imaging acquisition, thermic and metabolic homeostasis.
Results. We enrolled 23 consecutive preterm babies born < 37 weeks Gestational Age, candidate to sedation for an elective magnetic resonance imaging. All patients completed the radiological procedure in 30 minutes (SD ±6.39 minutes) without complications requiring exam interruption. Only one patient (4%) experienced a transient desaturation, while 2 neonates (9%) showed apnea lasting > 20 seconds. On average, there was a 1°C decrease in body temperature and full enteral feeding was resumed within 1.5 hours. Neuroradiologists rated the quality of the images obtained as high.
Conclusions. The lateral lying seems to be a viable option for sedated preterm babies during magnetic resonance imaging with a low risk of apnea and a reduced impact on thermic and metabolic homeostasis. Quality of imaging would be preserved maintaining correct scheduling of standard care.