Chest CT in children: anesthesia and atelectasis

Abstract

Controlled-ventilation infant CT scanning under general anesthesia, utilizing intubation and recruitment maneuvers followed by chest CT scans, appears to be a safe and effective method to obtain reliable and reproducible high-quality, motion-free chest CT images in children.

B‐Lines on Pediatric Lung Sonography

“…When general anesthesia was needed for CT, sonography was mostly performed in the recovery room after the CT study. Atelectasis due to hypoventilation occurs frequently in healthy lungs investigated for other reasons 21 . Anesthesia‐induced atelectasis has been seen on lung sonography as subpleural consolidations, irregularities of the pleural line, air bronchograms, and B‐lines when compared to magnetic resonance imaging 8 …”

“…Atelectasis due to hypoventilation occurs frequently in healthy lungs investigated for other reasons. 21 Anesthesia-induced atelectasis has been seen on lung sonography as subpleural consolidations, irregularities of the pleural line, air bronchograms, and B-lines when compared to magnetic resonance imaging. 8 In this study, there were 15 patients with no changes on CT who were studied without general anesthesia: 10 of these showed no B-lines; 4 had 1 to 4 B-lines; and 1 patient had 16 B-lines.…”

CT chest under general anesthesia: pulmonary, anesthetic and radiologic dilemmas

“…A well-designed protocol with input from the anesthesia, radiology and pulmonary departments is essential to obtain an optimal CT chest evaluation under anesthesia. A recent publication by Newman et al [15] concluded that controlledventilation infant CT scanning under general anesthesia, utilizing intubation and recruitment maneuvers followed by chest CT scans, appears to be a safe and effective method to obtain reliable and reproducible high-quality, motion-free and atelectasis-free chest CT images in children. This study describes how collaboration among the anesthesiology, pulmonology and radiology departments leads to developing a standardized controlled-ventilation CT technique and eventually a high-quality study [15].…”

High-Pitch Computed Tomography of the Lung in Pediatric Patients: An Intraindividual Comparison of Image Quality and Radiation Dose to Conventional 64-MDCT

“…Sargent et al showed significant atelectases in up to 68 % of children undergoing CT under sedation [20]. Even using optimized ventilation protocols, there still can be atelectases found in up to 29 % of examinations as recently shown by Newmann et al [21]. Radiation exposure is another important aspect in pediatric CT.…”