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
Hauptverfasser: 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
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container_start_page 290
container_title The Journal of surgical research
container_volume 299
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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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. 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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. 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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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