Deep sedation for cardiac magnetic resonance imaging: A comparison with cardiac anesthesia
Deep sedation for cardiac magnetic resonance imaging: A comparison with cardiac anesthesia
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DOI：
10.1016/j.jpeds.2007.08.045
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发表时间：
2008-04-01
影响因子：
5.1
通讯作者：
Concepcion, Mikael
中科院分区：
文献类型：
--
作者：
Fogel, Mark A.;Weinberg, Paul M.;Concepcion, Mikael
目的 检验先天性心脏病 (CHD) 接受深度镇静心脏磁共振成像 (CMR) 治疗的儿科患者的安全性、有效性和图像质量与全身麻醉 (GA) 相似的假设。研究设计 对 1997-2006 年所有 CMR 记录进行回顾性审查。 660 名患者接受了深度镇静 (DS)，161 名患者接受了 GA。统计数据包括方差分析、chi(2) 分析和变异系数。结果 诊断包括广泛的 CHD。没有因 DS 导致死亡和住院等严重不良事件 (A-E) 发生。 DS组有18例（2.8%）自限性事件，成功率为97.9%。接受 GA 的患者的 AE 率为 3.9% (n = 6)，其中包括 2 次住院过夜，成功率为 100%。两组之间的 AE 和成功率没有差异。对患者组不知情的观察者发现图像质量没有差异。即使在年幼的婴儿中，也能获得出色的图像质量。 结论 对接受 CMR 的适当筛查的 CHD 儿科患者进行镇静是安全的且耐受性良好，并且可产生与 GA 类似的高质量图像。对于血流动力学或气道受损、镇静失败或有特殊情况的先心病患者，应考虑进行 GA。
Objective To test the hypothesis that safety, efficacy, and image quality in pediatric patients who undergo deep sedation for cardiac magnetic resonance imaging (CMR) for congenital heart disease (CHD) is similar to general anesthesia (GA).Study design Retrospective review of all CMR records from 1997-2006. Six hundred sixty patients underwent deep sedation (DS) and 161 underwent GA. Statistics included analysis of variance, chi(2) analysis, and the coefficient of variation.Results Diagnoses included a broad spectrum of CHD. No serious adverse events (A-E) including mortalities and hospitalizations occurred because of DS. There were 18 (2.8%) self-limited events in the DS group with a success rate of 97.9%. The AE rate for patients undergoing GA was 3.9% (n = 6), including 2 overnight hospital stays with a success rate of 100%. AE and success rates did not differ between the 2 groups. Observers blinded to the patient's group found no difference in image quality. Even in young infants, excellent image quality was obtained.Conclusions Sedation of appropriately screened pediatric patients with CHD undergoing CMR is safe and well tolerated and yields high-quality images similar to GA. GA should be considered for patients with CHD with hemodynamic or airway compromise, in whom sedation has failed, or who have special circumstances.