Point-of-Care Bedside Brain Magnetic Resonance Imaging Is Safe in Extracorporeal Membrane Oxygenation Patients With Swan Ganz Catheters: A Phantom Experiment and Single Center Experience
More than 1.2 million pulmonary artery catheters (PACs) are used in cardiac patients per annum within the United States. However, it is contraindicated in traditional 1.5 and 3T magnetic resonance imaging (MRI) scans. We aimed to test preclinical and clinical safety of using this imaging modality gi...
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Veröffentlicht in: | The Journal of surgical research 2024-07, Vol.299, p.290-297 |
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creator | Chinedozi, Ifeanyi D. Boskamp, Eddy Darby, Zachary Kang, Jin Kook Rando, Hannah Sair, Haris Pitt, John Wilcox, Christopher Kim, Bo Soo Khanduja, Shivalika Whitman, Glenn Cho, Sung-Min |
description | More than 1.2 million pulmonary artery catheters (PACs) are used in cardiac patients per annum within the United States. However, it is contraindicated in traditional 1.5 and 3T magnetic resonance imaging (MRI) scans. We aimed to test preclinical and clinical safety of using this imaging modality given the potential utility of needing it in the clinical setting.
We conducted two phantom experiments to ensure that the electromagnetic field power deposition associated with bare and jacketed PACs was safe and within the acceptable limit established by the Food and Drug Administration. The primary end points were the safety and feasibility of performing Point-of-Care (POC) MRI without imaging-related adverse events. We performed a preclinical computational electromagnetic simulation and evaluated these findings in nine patients with PACs on veno-arterial extracorporeal membrane oxygenation.
The phantom experiments showed that the baseline point specific absorption rate through the head averaged 0.4 W/kg. In both the bare and jacketed catheters, the highest net specific absorption rates were at the neck entry point and tip but were negligible and unlikely to cause any heat-related tissue or catheter damage. In nine patients (median age 66, interquartile range 42-72 y) with veno-arterial extracorporeal membrane oxygenation due to cardiogenic shock and PACs placed for close hemodynamic monitoring, POC MRI was safe and feasible with good diagnostic imaging quality.
Adult ECMO patients with PACs can safely undergo point-of-care low-field (64 mT) brain MRI within a reasonable timeframe in an intensive care unit setting to assess for acute brain injury that might otherwise be missed with conventional head computed tomography. |
doi_str_mv | 10.1016/j.jss.2024.04.045 |
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We conducted two phantom experiments to ensure that the electromagnetic field power deposition associated with bare and jacketed PACs was safe and within the acceptable limit established by the Food and Drug Administration. The primary end points were the safety and feasibility of performing Point-of-Care (POC) MRI without imaging-related adverse events. We performed a preclinical computational electromagnetic simulation and evaluated these findings in nine patients with PACs on veno-arterial extracorporeal membrane oxygenation.
The phantom experiments showed that the baseline point specific absorption rate through the head averaged 0.4 W/kg. In both the bare and jacketed catheters, the highest net specific absorption rates were at the neck entry point and tip but were negligible and unlikely to cause any heat-related tissue or catheter damage. In nine patients (median age 66, interquartile range 42-72 y) with veno-arterial extracorporeal membrane oxygenation due to cardiogenic shock and PACs placed for close hemodynamic monitoring, POC MRI was safe and feasible with good diagnostic imaging quality.
Adult ECMO patients with PACs can safely undergo point-of-care low-field (64 mT) brain MRI within a reasonable timeframe in an intensive care unit setting to assess for acute brain injury that might otherwise be missed with conventional head computed tomography.</description><identifier>ISSN: 0022-4804</identifier><identifier>ISSN: 1095-8673</identifier><identifier>EISSN: 1095-8673</identifier><identifier>DOI: 10.1016/j.jss.2024.04.045</identifier><identifier>PMID: 38788465</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Acute brain injury (ABI) ; Adult ; Aged ; Brain - diagnostic imaging ; Cardiogenic shock ; Catheterization, Swan-Ganz - adverse effects ; Catheterization, Swan-Ganz - instrumentation ; Extracorporeal membrane oxygenation (ECMO) ; Extracorporeal Membrane Oxygenation - adverse effects ; Extracorporeal Membrane Oxygenation - instrumentation ; Extracorporeal Membrane Oxygenation - methods ; Feasibility Studies ; Female ; Hemodynamic monitoring ; Humans ; Magnetic Resonance Imaging - adverse effects ; Magnetic Resonance Imaging - methods ; Male ; Middle Aged ; Phantoms, Imaging ; Point-of-Care Systems ; Portable MRI ; Pulmonary artery catheter (PAC)</subject><ispartof>The Journal of surgical research, 2024-07, Vol.299, p.290-297</ispartof><rights>2024 Elsevier Inc.</rights><rights>Copyright © 2024 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c305t-ac66e40f5511973688e6f710555e577347f324a42b04a0d503d5162ec48b3a873</cites><orcidid>0000-0001-7012-5931 ; 0000-0002-5132-0958</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jss.2024.04.045$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,782,786,3552,27931,27932,46002</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38788465$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chinedozi, Ifeanyi D.</creatorcontrib><creatorcontrib>Boskamp, Eddy</creatorcontrib><creatorcontrib>Darby, Zachary</creatorcontrib><creatorcontrib>Kang, Jin Kook</creatorcontrib><creatorcontrib>Rando, Hannah</creatorcontrib><creatorcontrib>Sair, Haris</creatorcontrib><creatorcontrib>Pitt, John</creatorcontrib><creatorcontrib>Wilcox, Christopher</creatorcontrib><creatorcontrib>Kim, Bo Soo</creatorcontrib><creatorcontrib>Khanduja, Shivalika</creatorcontrib><creatorcontrib>Whitman, Glenn</creatorcontrib><creatorcontrib>Cho, Sung-Min</creatorcontrib><title>Point-of-Care Bedside Brain Magnetic Resonance Imaging Is Safe in Extracorporeal Membrane Oxygenation Patients With Swan Ganz Catheters: A Phantom Experiment and Single Center Experience</title><title>The Journal of surgical research</title><addtitle>J Surg Res</addtitle><description>More than 1.2 million pulmonary artery catheters (PACs) are used in cardiac patients per annum within the United States. However, it is contraindicated in traditional 1.5 and 3T magnetic resonance imaging (MRI) scans. We aimed to test preclinical and clinical safety of using this imaging modality given the potential utility of needing it in the clinical setting.
We conducted two phantom experiments to ensure that the electromagnetic field power deposition associated with bare and jacketed PACs was safe and within the acceptable limit established by the Food and Drug Administration. The primary end points were the safety and feasibility of performing Point-of-Care (POC) MRI without imaging-related adverse events. We performed a preclinical computational electromagnetic simulation and evaluated these findings in nine patients with PACs on veno-arterial extracorporeal membrane oxygenation.
The phantom experiments showed that the baseline point specific absorption rate through the head averaged 0.4 W/kg. In both the bare and jacketed catheters, the highest net specific absorption rates were at the neck entry point and tip but were negligible and unlikely to cause any heat-related tissue or catheter damage. In nine patients (median age 66, interquartile range 42-72 y) with veno-arterial extracorporeal membrane oxygenation due to cardiogenic shock and PACs placed for close hemodynamic monitoring, POC MRI was safe and feasible with good diagnostic imaging quality.
Adult ECMO patients with PACs can safely undergo point-of-care low-field (64 mT) brain MRI within a reasonable timeframe in an intensive care unit setting to assess for acute brain injury that might otherwise be missed with conventional head computed tomography.</description><subject>Acute brain injury (ABI)</subject><subject>Adult</subject><subject>Aged</subject><subject>Brain - diagnostic imaging</subject><subject>Cardiogenic shock</subject><subject>Catheterization, Swan-Ganz - adverse effects</subject><subject>Catheterization, Swan-Ganz - instrumentation</subject><subject>Extracorporeal membrane oxygenation (ECMO)</subject><subject>Extracorporeal Membrane Oxygenation - adverse effects</subject><subject>Extracorporeal Membrane Oxygenation - instrumentation</subject><subject>Extracorporeal Membrane Oxygenation - methods</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Hemodynamic monitoring</subject><subject>Humans</subject><subject>Magnetic Resonance Imaging - adverse effects</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Phantoms, Imaging</subject><subject>Point-of-Care Systems</subject><subject>Portable MRI</subject><subject>Pulmonary artery catheter (PAC)</subject><issn>0022-4804</issn><issn>1095-8673</issn><issn>1095-8673</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcFuEzEQhi0EoqHwAFyQj1w22Gt7dwOnsiptpFaNCIijNfHOJo527WA70PJoPF0dEjgijTQa-Zvf_v0T8pqzKWe8eredbmOclqyUU3Yo9YRMOJupoqlq8ZRMGCvLQjZMnpEXMW5Znme1eE7ORFM3jazUhPxeeOtS4fuihYD0I3bRdrkHsI7ewtphsoZ-xugdOIN0PsLaujWdR7qEHmmmLu9TAOPDzgeEgd7iuArgkN7dP6zRQbLe0UVu6FKk32za0OVPcPQK3C_aQtpgwhDf0wu62IBLfsyCOwx2zDwF19Flvm9A2uYZw-kQ81tekmc9DBFfnfo5-frp8kt7XdzcXc3bi5vCCKZSAaaqULJeKc6z-6ppsOprzpRSqOpayLoXpQRZrpgE1ikmOsWrEo1sVgKaWpyTt0fdXfDf9xiTHm00OAzZpN9HLVjFRC1LNcsoP6Im-BgD9nqXjUB40JzpQ2R6q3Nk-hCZZodSeefNSX6_GrH7t_E3owx8OAKYTf6wGHQ0fz6gswFN0p23_5F_BDqiqEM</recordid><startdate>202407</startdate><enddate>202407</enddate><creator>Chinedozi, Ifeanyi D.</creator><creator>Boskamp, Eddy</creator><creator>Darby, Zachary</creator><creator>Kang, Jin Kook</creator><creator>Rando, Hannah</creator><creator>Sair, Haris</creator><creator>Pitt, John</creator><creator>Wilcox, Christopher</creator><creator>Kim, Bo Soo</creator><creator>Khanduja, Shivalika</creator><creator>Whitman, Glenn</creator><creator>Cho, Sung-Min</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7012-5931</orcidid><orcidid>https://orcid.org/0000-0002-5132-0958</orcidid></search><sort><creationdate>202407</creationdate><title>Point-of-Care Bedside Brain Magnetic Resonance Imaging Is Safe in Extracorporeal Membrane Oxygenation Patients With Swan Ganz Catheters: A Phantom Experiment and Single Center Experience</title><author>Chinedozi, Ifeanyi D. ; Boskamp, Eddy ; Darby, Zachary ; Kang, Jin Kook ; Rando, Hannah ; Sair, Haris ; Pitt, John ; Wilcox, Christopher ; Kim, Bo Soo ; Khanduja, Shivalika ; Whitman, Glenn ; Cho, Sung-Min</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c305t-ac66e40f5511973688e6f710555e577347f324a42b04a0d503d5162ec48b3a873</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Acute brain injury (ABI)</topic><topic>Adult</topic><topic>Aged</topic><topic>Brain - diagnostic imaging</topic><topic>Cardiogenic shock</topic><topic>Catheterization, Swan-Ganz - adverse effects</topic><topic>Catheterization, Swan-Ganz - instrumentation</topic><topic>Extracorporeal membrane oxygenation (ECMO)</topic><topic>Extracorporeal Membrane Oxygenation - adverse effects</topic><topic>Extracorporeal Membrane Oxygenation - instrumentation</topic><topic>Extracorporeal Membrane Oxygenation - methods</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Hemodynamic monitoring</topic><topic>Humans</topic><topic>Magnetic Resonance Imaging - adverse effects</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Phantoms, Imaging</topic><topic>Point-of-Care Systems</topic><topic>Portable MRI</topic><topic>Pulmonary artery catheter (PAC)</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chinedozi, Ifeanyi D.</creatorcontrib><creatorcontrib>Boskamp, Eddy</creatorcontrib><creatorcontrib>Darby, Zachary</creatorcontrib><creatorcontrib>Kang, Jin Kook</creatorcontrib><creatorcontrib>Rando, Hannah</creatorcontrib><creatorcontrib>Sair, Haris</creatorcontrib><creatorcontrib>Pitt, John</creatorcontrib><creatorcontrib>Wilcox, Christopher</creatorcontrib><creatorcontrib>Kim, Bo Soo</creatorcontrib><creatorcontrib>Khanduja, Shivalika</creatorcontrib><creatorcontrib>Whitman, Glenn</creatorcontrib><creatorcontrib>Cho, Sung-Min</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of surgical research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chinedozi, Ifeanyi D.</au><au>Boskamp, Eddy</au><au>Darby, Zachary</au><au>Kang, Jin Kook</au><au>Rando, Hannah</au><au>Sair, Haris</au><au>Pitt, John</au><au>Wilcox, Christopher</au><au>Kim, Bo Soo</au><au>Khanduja, Shivalika</au><au>Whitman, Glenn</au><au>Cho, Sung-Min</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Point-of-Care Bedside Brain Magnetic Resonance Imaging Is Safe in Extracorporeal Membrane Oxygenation Patients With Swan Ganz Catheters: A Phantom Experiment and Single Center Experience</atitle><jtitle>The Journal of surgical research</jtitle><addtitle>J Surg Res</addtitle><date>2024-07</date><risdate>2024</risdate><volume>299</volume><spage>290</spage><epage>297</epage><pages>290-297</pages><issn>0022-4804</issn><issn>1095-8673</issn><eissn>1095-8673</eissn><abstract>More than 1.2 million pulmonary artery catheters (PACs) are used in cardiac patients per annum within the United States. However, it is contraindicated in traditional 1.5 and 3T magnetic resonance imaging (MRI) scans. We aimed to test preclinical and clinical safety of using this imaging modality given the potential utility of needing it in the clinical setting.
We conducted two phantom experiments to ensure that the electromagnetic field power deposition associated with bare and jacketed PACs was safe and within the acceptable limit established by the Food and Drug Administration. The primary end points were the safety and feasibility of performing Point-of-Care (POC) MRI without imaging-related adverse events. We performed a preclinical computational electromagnetic simulation and evaluated these findings in nine patients with PACs on veno-arterial extracorporeal membrane oxygenation.
The phantom experiments showed that the baseline point specific absorption rate through the head averaged 0.4 W/kg. In both the bare and jacketed catheters, the highest net specific absorption rates were at the neck entry point and tip but were negligible and unlikely to cause any heat-related tissue or catheter damage. In nine patients (median age 66, interquartile range 42-72 y) with veno-arterial extracorporeal membrane oxygenation due to cardiogenic shock and PACs placed for close hemodynamic monitoring, POC MRI was safe and feasible with good diagnostic imaging quality.
Adult ECMO patients with PACs can safely undergo point-of-care low-field (64 mT) brain MRI within a reasonable timeframe in an intensive care unit setting to assess for acute brain injury that might otherwise be missed with conventional head computed tomography.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>38788465</pmid><doi>10.1016/j.jss.2024.04.045</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-7012-5931</orcidid><orcidid>https://orcid.org/0000-0002-5132-0958</orcidid></addata></record> |
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subjects | Acute brain injury (ABI) Adult Aged Brain - diagnostic imaging Cardiogenic shock Catheterization, Swan-Ganz - adverse effects Catheterization, Swan-Ganz - instrumentation Extracorporeal membrane oxygenation (ECMO) Extracorporeal Membrane Oxygenation - adverse effects Extracorporeal Membrane Oxygenation - instrumentation Extracorporeal Membrane Oxygenation - methods Feasibility Studies Female Hemodynamic monitoring Humans Magnetic Resonance Imaging - adverse effects Magnetic Resonance Imaging - methods Male Middle Aged Phantoms, Imaging Point-of-Care Systems Portable MRI Pulmonary artery catheter (PAC) |
title | Point-of-Care Bedside Brain Magnetic Resonance Imaging Is Safe in Extracorporeal Membrane Oxygenation Patients With Swan Ganz Catheters: A Phantom Experiment and Single Center Experience |
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