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Safety of ferumoxytol in children undergoing cardiac MRI under general anaesthesia

Published online by Cambridge University Press:  31 May 2018

Lisa Wise-Faberowski ,
Nathalia Velasquez ,
Frandics Chan ,
Shreyas Vasanawala ,
Doff B. McElhinney  and
Chandra Ramamoorthy
Lisa Wise-Faberowski*
Affiliation:
Lucile Packard Children’s Hospital Heart Center, Stanford University School of Medicine, Palo Alto, CA, USA Department of Anesthesiology, Stanford University School of Medicine, Palo Alto, CA, USA
Nathalia Velasquez
Affiliation:
Lucile Packard Children’s Hospital Heart Center, Stanford University School of Medicine, Palo Alto, CA, USA
Frandics Chan
Affiliation:
Lucile Packard Children’s Hospital Heart Center, Stanford University School of Medicine, Palo Alto, CA, USA Department of Radiology, Stanford University School of Medicine, Palo Alto, CA, USA
Shreyas Vasanawala
Affiliation:
Lucile Packard Children’s Hospital Heart Center, Stanford University School of Medicine, Palo Alto, CA, USA Department of Radiology, Stanford University School of Medicine, Palo Alto, CA, USA
Doff B. McElhinney
Affiliation:
Lucile Packard Children’s Hospital Heart Center, Stanford University School of Medicine, Palo Alto, CA, USA Department of Cardiothoracic Surgery, Stanford University School of Medicine, Palo Alto, CA, USA
Chandra Ramamoorthy
Affiliation:
Lucile Packard Children’s Hospital Heart Center, Stanford University School of Medicine, Palo Alto, CA, USA Department of Anesthesiology, Stanford University School of Medicine, Palo Alto, CA, USA
*
Author for correspondence: L. Wise-Faberowski, Department of Anesthesiology, Stanford University/Lucile Packard Children’s Hospital, 300 Pasteur Drive, Palo Alto, CA 94305, USA. Tel: 650 24 1705; Fax: 650 725 8544; E-mail: lwf1212@stanford.edu
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Abstract

Background

Ferumoxytol, an “off-label” contrast agent, allows for better cardiac MRI quality as compared with gadolinium-based contrast agents. However, hypotension has been reported with the use of ferumoxytol for indications other than cardiac MRI. The purpose of our investigation was to evaluate the safety of ferumoxytol in children undergoing general anaesthesia for cardiac MRI.

Methods

Medical records of children undergoing general anaesthesia for cardiac MRI were reviewed. Baseline demographic and medical characteristics, as well as imaging and anaesthetic duration and technique, were collected. The incidence of hypotension or other adverse events’, need for vasoactive support, or airway intervention throughout the anaesthetic, was recorded.

Results

A total of 95 patients were identified, 61 received ferumoxytol and 34 received gadolinium. There were no significant differences between groups with respect to age, weight, or baseline blood pressure. The incidence of low blood pressure – systolic or mean – after contrast administration did not differ between groups, and there was no difference in sustained hypotension or use of vasopressors between groups. One patient who received ferumoxytol had possible anaphylaxis. The image acquisition time (45 versus 68 min, p=0.002) and anaesthesia duration (100 versus 132 min, p=0.02) were shorter in the ferumoxytol group.

Conclusion

Transient low blood pressure was common in children undergoing cardiac MRI with anaesthesia, but the incidence of hypotension did not differ between ferumoxytol and gadolinium groups. The use of ferumoxytol was associated with significantly shorter scan time and anaesthesia duration, as well as a decreased need for airway intervention.

Keywords

MRIferumoxytolpaediatriccardiac
Type
Original Articles
Information
Cardiology in the Young , Volume 28 , Issue 7 , July 2018 , pp. 916 - 921
Copyright
© Cambridge University Press 2018 

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