Background and aim Magnetic Resonance Imaging (MRI) of the brain at 30 weeks Postmenstrual age (PMA) is part of routine care for preterms born <28 weeks gestational age (GA), because of their high risk of brain injury.
The aim was to evaluate fluctuations in vital parameters following the MRI procedure.
Methods and patients We compared clinical parameters in 30 infants 4 h before and after the MRI: number of apneas and bradycardias, changes in oxygen requirement, respiratory support, and rectal temperature. Oral chloralhydrate sedation (30–50 mg/kg) was administered upon discretion of the attending neonatologist.
Results Infants had the following clinical characteristics: mean GA 26 + 4 wks (24–28 wks), mean BW 1012 g (610–1520 g), PMA at scan was 30 + 6 wks (29 + 6–31 + 6 wks) with weight of 1397 g (980–1860 g). Infants <1500 g, were transported in an MRI-compatible incubator (26/30). 12/30 (40%) infants were sedated with chloralhydrate.
None of the infants had >4 apneas or >3 bradycardias before the MRI. After the MRI 5 infants (all unsedated) had >4 apneas (5–7 apneas), 2 infants (1 sedated) had >3 bradycardias (5–6). After the MRI, FiO2 was increased in 10/30 patients, max change 0.06, more respiratory support was needed in 5 infants (3 sedated): PEEP from +4 to PEEP +5 cmH2O, and temperature was lower in 20/30 patients, max decrease 1,3°C (before 37.1°C (36.3–37.9°C) vs. 36.6°C (35.9–37.4°C)).
Conclusions Early MRI scanning using an MRI incubator is a relatively safe procedure in clinically stable infants. Use of sedation was not associated with clinically relevant changes, although these findings warrant further investigation.