title: A prospective audit of safety issues associated with general anesthesia for pediatric cardiac magnetic resonance imaging.
abstract: OBJECTIVE
  Cardiac MRI (CMR) is increasingly used for surgical planning and serial monitoring of children with congenital heart disease (CHD). For small children, general anesthesia (GA) is required. We describe our experience of the safety of GA for pediatric CMR, using data collected prospectively over 3 years.
  
  
  METHODS
  All consecutive infants undergoing GA for CMR at our institution, between November 2005 and May 2008, were included. Informed and written consent to participate in research investigation was acquired from the guardians of every patient prior to CMR. The cardiac anesthetist completed a standardized data collection form during each procedure. Information collected included demographics, diagnosis, surgical history, anesthetic management, significant incidents, and discharge circumstances.
  
  
  RESULTS
  A total of 120 patients with varying cardiac physiology and a range of hemodynamics underwent GA for CMR during the study period. Gas induction was predominantly used, even in those with impaired ventricular function. The majority (71%) of procedures were undertaken without significant incident. Minor adverse incidents were recorded in 32 patients, mild hypotension being most frequent. One major adverse event occurred. A patient with hypoplastic left heart syndrome (HLHS) suffered hypotension then cardiac arrest in the scanner. This patient was successfully resuscitated.
  
  
  CONCLUSIONS
  Although the majority of cases were safe and without incident, the complication rate in children with CHD receiving a GA for CMR is higher than in the general pediatric population. This reinforces the need for a senior, multidisciplinary team to be involved in the care of these children during imaging.
authors.affiliation: Department of Anaesthesia, Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London, UK. stocke@gosh.nhs.uk
authors.forename: Emma
authors.initials: E
authors.lastname: Stockton
authors.forename: Marina
authors.initials: M
authors.lastname: Hughes
authors.forename: Mike
authors.initials: M
authors.lastname: Broadhead
authors.forename: Andrew
authors.initials: A
authors.lastname: Taylor
authors.forename: Angus
authors.initials: A
authors.lastname: McEwan
mesh_terms: D000293:Adolescent; D000328:Adult; D000768:Anesthesia, General / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000473:pathology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D008485:Medical Audit / Q000706:statistics & numerical data*; D009206:Myocardium / Q000473:pathology; D061214:Patient Safety / Q000706:statistics & numerical data*; D011446:Prospective Studies; D055815:Young Adult