The impact of preparation and support procedures for children with sickle cell disease undergoing MRI.
BACKGROUND
Children with sickle cell disease (SCD) often undergo MRI studies to assess brain injury or to quantify hepatic iron. MRI requires the child to lie motionless for 30-60 min, thus sedation/anesthesia might be used to facilitate successful completion of exams, but this poses additional risks for SCD patients. To improve children's ability to cope with MRI examinations and avoid sedation, our institution established preparation and support procedures (PSP).


OBJECTIVE
To investigate the impact of PSP in reducing the need for sedation during MRI exams among children with SCD.


METHODS
Data on successful completion of MRI testing were compared among 5- to 12-year-olds who underwent brain MRI or liver R2*MRI with or without receiving PSP.


RESULTS
Seventy-one children with SCD (median age 9.85 years, range 5.57-12.99 years) underwent a brain MRI (n = 60) or liver R2*MRI (n = 11). Children who received PSP were more likely to complete an interpretable MRI exam than those who did not (30 of 33; 91% vs. 27 of 38; 71%, unadjusted OR = 4.1 (P = 0.04) and OR = 8.5 (P < 0.01) when adjusting for age.


CONCLUSIONS
PSP can help young children with SCD complete clinically interpretable, nonsedated MRI exams, avoiding the risks of sedation/anesthesia.
Child Life Program, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop 121, Memphis, TN 38105, USA. katherine.cejda@stjude.org
Katherine R
KR
Cejda
Matthew P
MP
Smeltzer
Eileen N
EN
Hansbury
Mary Elizabeth
ME
McCarville
Kathleen J
KJ
Helton
Jane S
JS
Hankins
D000755:Anemia, Sickle Cell / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D001927:Brain Diseases / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation / Q000379:methods* / Q000523:psychology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods* / Q000523:psychology; D010353:Patient Education as Topic / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity