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PEDIATRIC ANESTHESIA

Iatrogenic Hyperthermia During Cardiac Magnetic Resonance Imaging

Barry D. Kussman, MBBCh FFA(SA)^*,¶, Robert V. Mulkern, PhD^,, and Robert S. Holzman, MD^*,¶

Departments of *Anesthesiology, Perioperative and Pain Medicine, and Radiology, Children’s Hospital Boston; and Departments of ¶Anaesthesia and Radiology, Harvard Medical School, Boston, Massachusetts

Address correspondence and reprint requests to Barry D. Kussman, MBBCh, FFA(SA), Department of Anesthesiology, Perioperative and Pain Medicine, Children’s Hospital, 300 Longwood Ave., Boston, MA 02115. Address e-mail to barry. kussman{at}childrens.harvard.edu

We report the occurrence of accidental hyperthermia in a young child undergoing anesthesia for cardiac magnetic resonance imaging. Although the tendency during anesthesia is to develop hypothermia, the absorbed radiofrequency energy from magnetic resonance scanning is added to metabolic energy and must be balanced by appropriate heat loss to maintain normothermia. In addition to stressing the clinical importance of temperature monitoring, this report suggests that the recommended specific absorption rates to prevent excessive patient heating may need to be revised for infants and young children.

IMPLICATIONS: Radiofrequency energy absorbed during magnetic resonance imaging (MRI) is added to metabolic energy and must be balanced by appropriate heat loss to maintain normothermia. Although hypothermia is more likely during anesthesia for MRI, this report of hyperthermia stresses the importance of temperature monitoring, particularly for long scans with high-energy sequences.

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