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A Safer NICU-to-MRI Transport

October 26, 2011


NICU nurses Julie Williams, left, and Nancy Tuttle look over the unit’s new MR incubator with pediatric radiologist Thierry Huisman.

During delivery a pre-term infant suffers hypoxic-ischemic injury, the most common cause of neonatal encephalopathy. To provide optimal treatment, magnetic resonance imaging (MRI) is needed fast to guide decisions about therapeutic options that may limit irreversible damage to the brain. But the traditional transport from the Neonatal Intensive Care Unit (NICU) to the MR suite is not without risks, as the fragile infant must be moved from one incubator to another, along with multiple lines and tubes for supportive medications and fluids. On the way to the MR suite there’s the potential danger of getting stuck in an elevator, bumping into the transport unit, or losing power, and safely arriving at the MR suite doesn’t mean the job is over.

“When we transfer the neonate from the temperature-controlled environment of the transport incubator into the MR scanner, we’re at risk of pulling out lines and exposing the infant to all kinds of stress-related complications like dehydration and hypothermia,” says pediatric radiologist Thierry Huisman. He adds, “A MR technologist might sneeze and we’ve increased the neonate’s viral load.”

No more. In a collaborative effort the NICU and the Division of Pediatric Radiology at Johns Hopkins Children’s have significantly reduced such risks through the acquisition of a MR-compatible incubator that fits as a complete unit into the MR scanner itself. The neonate is transferred into the MR-combatible incubator in the NICU, and from that point on no one touches the baby.

“It is set up in such a way that we can put our imaging equipment around the infant without having to take the baby out of the incubator,” says Huisman. “All of the monitoring and other equipment is MR compatible.”

The MR incubator is independent with its own power source and MR adapted features, including titanium oxygen tanks to avoid the rare but potentially dangerous risk of non-compatible metal oxygen tanks flying into the MR machine’s magnetic bore. Time to treatment will be expedited, too, improving outcomes for neonatal patients.

“We have high-end anatomical and functional imaging that can detect what conventional imaging cannot,” says Huisman. “But you need to do MR imaging as early as possible to optimize treatment.”

For now, Huisman adds, the MR incubator is designed for patients with cerebral injury, though plans call for imaging patients with cardiac malformations and abdominal disorders in the future. For more information, call 410-955-6140.