Erasmus MC - Rotterdam

Describing the MRI-compatible Incubator with Ventilation Options

Nikk Connemann, MD
Neonatologist at Erasmus MC, Rotterdam

"Our aim was to have a tool that would make it possible for us to conveniently do brain scans of prematurely born infants with MRI, for both clinical and research options.

The MRI compatible incubator with ventilator possibilities gave us a unique tool to comfortably transport the preterm neonate within days after birth and do an MRI scan without having to sedate the preterm and still get perfect scans. To scan without the risk of hypothermia greatly enhances the cooperation of nursing staff and parents. Having a preterm on the ventilator and still be able to scan without lengthening respirator tubes reduces the risks of under-ventilation during scanning. And best of all we do not have to sedate the baby, all because the incubator will allow us to work in the NICU with the nurse who usually cares for the baby and knows him or her best.

When taking ample time, one can transfer the preterm into the MRI compatible incubator in the unit. With the coil in place we can position the baby´s head inside the coil and support the head with soft, yet firm little cushions between the coil and the sides of the infant’s head. By doing this, we ensure a stable head position. Of course, prior to positioning the head we have placed ear pads over the baby’s ears to reduce the sound overload. Along with the head we position the shoulders and rest of the body with small soft towels next to the shoulders and upper body, and being comfortably swaddled the baby falls asleep and doesn’t have to be moved into the MRI suite. The saturation monitor lead is positioned on the foot and allows for monitoring during the scanning.

All the preparation again is done in the NICU, leads are taken off, IV boards with iron are taken off, heart monitoring leads come off, the IV lines that will run during the scan are lengthened, and stay outside the MRI room during scan time. We take it slow and preparation from the time the MRI-compatible incubator is rolled onto the ward is about 45 minutes. After that we roll to the MRI suite and reconnect the air and oxygen supply to the wall sockets in the suite, position the pulse-oximeter, lift the incubator off the trolley onto the galley and the baby is ready to be scanned. By then all babies are asleep and hardly ever wake up during scanning, when they do, we stop scanning, take the incubator out, comfort the baby, sometimes adjusting the position, while still in the transport incubator. When the baby is settled again, we place him back into the scanner and continue.

After the scan we roll back to the unit and the baby is carefully placed back into it’s incubator, often still asleep. We invite parents to come along with us into the MRI scanner so they can see how comfortable their baby stays throughout the scan.

It’s a safe and convenient way to scan premature infants and get great results with reasonable effort."