Use of ventilation bag for the respiratory support during magnetic resonance imaging in Arnold-Chiari ventilated patients, a case report

Abstract

Context: Magnetic Resonance Imaging (MRI) is an essential diagnostic tool for neuroimaging tissues such as the spinal cord. Unfortunately, the use of MRI may be limited in ventilated patients, who cannot maintain the supine position in spontaneous breathing for the whole duration of the exam (i.e. neuro-muscular patients with diaphragm involvement). The use of MRI-compatible ventilator during MRI could be a solution but they are not universally available. Furthermore, their performances are not up to those of the conventional ones and they are not always compatible with Non Invasive Ventilation (NIV).

Findings: This case report describes an easy and low-cost solution to ventilate a patient non-invasively during the MRI procedure. The patient in this case was a 45-yr-old man, wheelchair-dependent and chronically ventilated in NIV with a forced vital capacity in supine position of 370 ml (10% of predicted normal), affected by Arnold-Chiari Syndrome, and in need of a MRI diagnostic control.

Conclusion: The technique proposed, that does not affect the MRI images quality, consists in ventilating the patient using a simple nonmetallic Ventilation Bag, operated by a Respiratory Therapist. This has been proven a useful and economical solution for ventilatory support during MRI for a respiratory-dependent patient with Arnold-Chiari Syndrome.

Keywords:

• Arnold-Chiari malformation"[Mesh]
• Magnetic resonance imaging [MeSH]
• Respiratory insufficiency [MeSH]
• Noninvasive ventilation [MeSH]
• Ventilation bag

Acknowledgment

We would like to thank Anna Rabitti for her help in translating this manuscript from Italian and Angela Pescolderung for graphic. The material in this manuscript has not been previously described or presented.

Disclaimer statements

Contributors Claudia Enrichi contributed to conception and design of the study, analyzed and interpreted data, drafted and revised the manuscript, and contributed to the approval of the final version of the manuscript. Cristiano Zanetti, Rosaria Stabile, Francesco Piccione, Carla Carollo, Luca Ghezzo analyzed and interpreted data, drafted and revised the manuscript, and contributed to the approval of the final version of the manuscript.

Funding None.

Declaration of interest None.

Conflicts of interest The authors report no potential conflict of interest.