Intervention helps children with sickle cell disease complete MRI tests without sedation

August 31, 2012
St. Jude Children's Research Hospital reports success in using a targeted educational approach to teach young sickle cell disease patients to remain motionless during MRI scans, making the process safer. Credit: St. Jude Biomedical Communications

Sitting still is tough for children, which makes MRI scans a challenge. The scans require that patients remain motionless for extended periods. Findings from St. Jude Children's Research Hospital showed that a brief, targeted intervention dramatically increases the likelihood that children as young as 5 years old will be able to undergo testing without sedation.

That is good news for children with sickle cell disease, who were the focus of this study. with sickle cell disease often undergo brain and liver MRIs to check for complications related to their disease or treatment. But the puts patients at increased risk for serious anesthesia-related complications, so is avoided when possible.

This study of 71 patients with sickle cell disease ages 5 through 12 found that children who completed the short preparation program prior to their MRI were eight times more likely to complete the scans without being sedated than patients of the same age who did not receive the preparation. The work was published online in the journal Pediatric Radiology.

The intervention implemented by the Child Life Program at St. Jude involves educating patients and families about exactly what to expect during an MRI, assigning patients jobs to focus on during the scans and also working to identify strategies to help them remain motionless during the test. "Some patients chose to listen to music or to squeeze a ball to help them remember not to move," said Katherine Cejda, a St. Jude Child Life specialist and the study's first author. "Some patients had the option of watching movies or having parents or other in the room with them during the test."

This study is the first designed to determine the effectiveness of this approach and the first to focus on children with sickle cell disease. Cejda said similar programs are used by child life specialists throughout the U.S. to help prepare children for MRIs and other . September is National Sickle Cell Awareness Month. This study highlights the varied efforts underway at St. Jude to improve the health and quality of life for children and adolescents with sickle cell disease.

The paper's senior author, Jane Hankins, M.D., an associate member of the St. Jude Department of Hematology, said that avoiding sedation reduces the risk to the patients, particularly those with sickle cell disease.

Sickle cell disease is caused by a mutation in the gene for assembling hemoglobin. Hemoglobin is the protein red blood cells use to carry oxygen throughout the body. While red blood cells are normally pliable discs, the inherited mistake results in red blood cells becoming brittle and assuming a banana shape that can trigger intense pain and lead to organ damage. Hankins said the disease also makes anesthesia riskier.

General anesthesia can lead to a drop in temperature, blood oxygen levels and dehydration. In patients with sickle cell disease, dehydration can result in a painful and dangerous buildup of sickled cells. Patients can wind up hospitalized, sometimes in the intensive care unit, for treatment of severe pain or acute chest syndrome, a pneumonia-like illness, Hankins said. To reduce that risk, a sickle cell patient scheduled for anesthesia is hospitalized overnight to receive extra fluids and possibly a blood transfusion.

The combination of factors creates inconvenience and added risk for the patient. It also adds to health care costs. While no family ever pays St. Jude for the care their child receives, controlling costs remains important to the hospital. The program could also be adopted by other health care institutions worldwide to help manage cost.

The intervention is now routinely offered to all St. Jude patients undergoing MRIs. Cejda said the program has been used to help children as young as age 4 complete scans without sedation. "This preparation program offers a real advantage to patients," Hankins added.

The study included children scheduled for or MRIs, which usually last 30 to 60 minutes. Researchers reported that 30 of the 33 , or 91 percent, in the intervention group underwent successful MRI scans without sedation. That compares to 71 percent, or 27 of 33 patients, who did not participate in the program prior to undergoing MRIs without sedation. The other authors are Matthew Smeltzer, Beth McCarville and Kathleen Helton, all of St. Jude, and Eileen Hansbury, formerly of St. Jude.

Explore further: Sickle cell anemia drug safe and effective for infants and toddlers, adds treatment option

Related Stories

Sickle cell anemia drug safe and effective for infants and toddlers, adds treatment option

May 12, 2011
New research shows a drug commonly used to treat sickle cell anemia in adults reduces bouts of acute pain and a pneumonia-like illness, cuts hospitalization time and eases other symptoms of the disease in young patients. ...

Researchers reveal potential treatment for sickle cell disease

November 2, 2011
A University of Michigan Health System laboratory study reveals a key trigger for producing normal red blood cells that could lead to a new treatment for those with sickle cell disease.

Recommended for you

Small drop in measles vaccinations would have outsized effect, study estimates

July 24, 2017
Small reductions in childhood measles vaccinations in the United States would produce disproportionately large increases in the number of measles cases and in related public health costs, according to a new study by researchers ...

At the cellular level, a child's loss of a father is associated with increased stress

July 18, 2017
The absence of a father—due to incarceration, death, separation or divorce—has adverse physical and behavioral consequences for a growing child. But little is known about the biological processes that underlie this link ...

New comparison chart sheds light on babies' tears

July 10, 2017
A chart that enables parents and clinicians to calculate if a baby is crying more than it should in the first three months of its life has been created by a Kingston University London researcher, following a study of colic ...

Blood of SIDS infants contains high levels of serotonin

July 3, 2017
Blood samples from infants who died of Sudden Infant Death Syndrome (SIDS) had high levels of serotonin, a chemical that carries signals along and between nerves, according to a study funded in part by the National Institutes ...

Is your child's 'penicillin allergy' real?

July 3, 2017
(HealthDay)—Many children suspected of being allergic to the inexpensive, first-line antibiotic penicillin actually aren't, new research indicates.

Probiotic supplements failed to prevent babies' infections

July 3, 2017
(HealthDay)—Probiotic supplements may not protect babies from catching colds or stomach bugs in day care, a new clinical trial suggests.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.