Atelectasis on pediatric chest CT: comparison of sedation techniques.
BACKGROUND
A change in practice at our institution resulted in increased use of anesthesia for CT scan of the chest in children who required sedation.


OBJECTIVE
To determine whether there is a difference in the frequency or severity of pulmonary atelectasis on CT scan in children sedated by anesthesiologists compared with children sedated by radiologists using intravenous pentobarbital.


METHODS
Retrospective blinded review of 60 CT scans of the chest performed in 41 children. Forty-one studies in children sedated by radiologists (median age 29 months) were compared with 19 studies in children sedated by anesthesiologists (median age 25 months).


RESULTS
Atelectasis sufficient to obscure pulmonary metastases was shown in 5 of 41 (12 %) radiology sedations and 13 of 19 (68 %) anesthesiology sedations (P < 0.01). Higher grades of atelectasis were recorded in children under anesthesia (P < 0.01).


CONCLUSIONS
Atelectasis is more frequent and more severe in children undergoing general anesthesia compared with intravenous pentobarbital sedation. Consideration should be given to the use of forced inspiration in children anesthetized for CT scan of the chest.
Department of Radiology, Children's & Women's Health Centre of British Columbia, 4500 Oak Street, Vancouver BC V6H 3N1, Canada.
M A
MA
Sargent
A M
AM
McEachern
D H
DH
Jamieson
R
R
Kahwaji
D000776:Anesthesiology / Q000379:methods; D018681:Anesthetics, General / Q000009:adverse effects*; D002648:Child; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects*; D007262:Infusions, Intravenous; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D010424:Pentobarbital / Q000008:administration & dosage / Q000009:adverse effects*; D001261:Pulmonary Atelectasis / Q000139:chemically induced*; D011871:Radiology / Q000379:methods; D012189:Retrospective Studies; D016037:Single-Blind Method; D014057:Tomography, X-Ray Computed
D018681:Anesthetics, General; D006993:Hypnotics and Sedatives; D010424:Pentobarbital