Abstract
Sedation can induce atelectasis which may cause suboptimal image quality. This study aimed to identify factors associated with the occurrence of atelectasis during sedation for imaging in pediatric patients. Patients < 18 years who had undergone whole-body magnetic resonance imaging (MRI) under sedation with propofol or dexmedetomidine were included in this study. The development of atelectasis was visually and quantitatively assessed by coronal short tau inversion recovery images of the thoracic level. Multivariable logistic regression was performed to identify the independent factors associated with the development of atelectasis. Ninety-one patients were included in the analysis. In the multivariable analysis, administration of supplemental oxygen was the only factor significantly associated with the occurrence of atelectasis (adjusted odds ratio, 4.84; 95% confidence interval, 1.48–15.83; p = 0.009). Univariable analysis showed that the use of dexmedetomidine was associated with a lower incidence of atelectasis; however, this could not be verified in the multivariable analysis. Among the pediatric patients who had undergone imaging under sedation, additional oxygen supplementation was the only independent factor associated with atelectasis occurrence. A prospective clinical trial is required to identify the cause-effect relationship between oxygen administration and occurrence of atelectasis during sedation.
Highlights
Prolonged sedation is inevitably required when performing imaging studies in young children who are uncooperative and more vulnerable to immobilization and noise exposure
Among the 114 potentially eligible patients, one patient was sedated with both propofol and dexmedetomidine, four patients had thoracic abnormalities, and 18 patients underwent whole-body magnetic resonance imaging (MRI) that did not follow the routine protocol; they were excluded
Fifty-seven and 34 patients were sedated with propofol and dexmedetomidine, respectively
Summary
Prolonged sedation is inevitably required when performing imaging studies in young children who are uncooperative and more vulnerable to immobilization and noise exposure. Sedation during imaging improves the quality of images and enhances workflow efficiency [1,2,3]. It requires additional medical resources and costs. Atelectasis can develop during sedation and cause dyspnea or fever, requiring additional hospitalization [5,6,7,8,9]. Atelectasis may obscure pulmonary parenchymal lesions and be misinterpreted as pneumonia, metastasis, or lymph node enlargement. It may increase the need for unnecessary additional imaging studies
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