Assessing the SAfety and FEasibility of bedside portable low-field brain Magnetic Resonance Imaging in patients on ECMO (SAFE-MRI ECMO study): study protocol and first case series experience
Sung-Min Cho,
Christopher Wilcox,
Steven Keller,
Matthew Acton,
Hannah Rando,
Eric Etchill,
Katherine Giuliano,
Errol L. Bush,
Haris I. Sair,
John Pitts,
Bo Soo Kim,
Glenn Whitman
Affiliations
Sung-Min Cho
Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine
Christopher Wilcox
Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine
Steven Keller
Department of Biomedical Engineering, Johns Hopkins University School of Medicine
Matthew Acton
Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine
Hannah Rando
Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine
Eric Etchill
Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine
Katherine Giuliano
Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine
Errol L. Bush
Division of Thoracic Surgery, Department of Surgery, Johns Hopkins University School of Medicine
Haris I. Sair
Division of Neuroradiology, Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine
John Pitts
Hyperfine
Bo Soo Kim
Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine
Glenn Whitman
Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine
Abstract Background To assess the safety and feasibility of imaging of the brain with a point-of-care (POC) magnetic resonance imaging (MRI) system in patients on extracorporeal membrane oxygenation (ECMO). Early detection of acute brain injury (ABI) is critical in improving survival for patients with ECMO support. Methods Patients from a single tertiary academic ECMO center who underwent head CT (HCT), followed by POC brain MRI examinations within 24 h following HCT while on ECMO. Primary outcomes were safety and feasibility, defined as completion of MRI examination without serious adverse events (SAEs). Secondary outcome was the quality of MR images in assessing ABIs. Results We report 3 consecutive adult patients (median age 47 years; 67% male) with veno-arterial (n = 1) and veno-venous ECMO (n = 2) (VA- and VV-ECMO) support. All patients were imaged successfully without SAEs. Times to complete POC brain MRI examinations were 34, 40, and 43 min. Two patients had ECMO suction events, resolved with fluid and repositioning. Two patients were found to have an unsuspected acute stroke, well visualized with MRI. Conclusions Adult patients with VA- or VV-ECMO support can be safely imaged with low-field POC brain MRI in the intensive care unit, allowing for the assessment of presence and timing of ABI.
