What vent do you use for MRI? We currently use the Omnivent and I am wondering if anyone out there has had any problems with peep valves functioning properly during an MRI due to the spring.

We switched over to a MRI-compatible Servo 900C a couple of years ago for several reasons.
1) The OMNI-Vent had several episodes of mega-peep imposed on our patients.
2) While we were evaluating the 900C and its effect vis-a-vis the MRI magnet on the imageing and its own operation, a group from Boston published in Resp Care (~2002) their experience with the 900C in MRI. This of course helped us validate the change to all involved.
3) We wanted to ventilate the MRI patients with pressure based breaths PCV/PSV due to the length of the tubing.

Anyway, if you're interested into how we did this, the pitfalls encountered, etc email me at costa.voutsinas@muhc.mcgill.ca

Hope this helps
CDNRt

If the staff hasn't worked with the Servo 900 at all..do you still think it's a good idea to try and locate one/fix up for MRI/train, etc.? That is the situation we are in.

I can see how if the Servo 900 was one of the old vents it would make great sense to convert for MRI---the old timers could keep the yung uns up on the nuances of it. But otherwise...?

My staff is currently trained and are using the Servo 900, but I am unsure though how to make it MRI compatible.

Jeff, I believe that the Servo 900 is the present-day way to go for MRI ventilation (unless of course you have the funds for an MRI compatible anesthesia machine...).

The article was by a group in Chicago, not Boston (probably the Red Sox effect):

Morgan SE, Kestner JJ, Hall JB, Tung A. Modification of a critical care ventilator for use during magnetic resonance imaging. Respir Care 2002 Jan; 47 (1): 61-68

The MRI kit by Siemens/Maquet is Part No 162 11 341 and was sold to us for $364.25(Cdn) back in Dec 2001. Don't expect much in this kit; a manual for your Biomedical guys, guidelines for usage, several parts that are switched on the 900C.

They actually quoted an MRI compatible mobile cart (to sit the Servo on, as well as other equipment) for $5776.04!!!!! That was shocking, even in Canadian funds. Therefore, we purchased a MRI cart from GE Medical Systems Canada for $375.00 (Cdn) January 1st, 2002.

We had used the 900C quite a bit during the 80s and early, early 90s so we had the same issues regarding getting the young pups to understand its intricacies regarding VT/Flow/Ti, etc. To make their life a bit easier, I plasticized a sheet that displays the 900C dashboard and drew up some suggested settings dependent upon the patient coming down for the scan. Typically, I asked the staff to place patients on PSV+ or PCV. This eliminates the (I need a calculator) factor when figuring out volumes/flows for the computer-schooled staff. As well, our anesthestists accompany some OR patients to MRI and you know well trained in ventilator management they can be (yuk-yuk).

We also purchased an MR fibreoptic laryngoscope for any A/W disasters.

I stress the importance of having the radiology engineers as well as the MRI-tech support people on board when you will be initially testing your equipment. They will ensure that the RadioFrequency fields emitted by the magnet will not affect the ventilator and related equipment (NIBP/SpO2) up to a certain distance (which should be clearly marked on the floor of the MRI suite.
As well, by doing their "phantom" testing while the ventilator is positioned properly, they will ensure that the MRI images are not affected by the RF emitted by the ventilator.

Sounds difficult but it really isn't. The importance of this testing is paramount (there was customer notification letter 2004-01-22)by maquet that reported that the patient trigger function was blocked during imageing sequences. How's that for keeping pt. RR less than 25! Their machine was too close to the magnet.

If you guys are interested in the paperwork involved in all of this, I'll gladly fax or snail-mail you a copy of everything I have.

Cdn RT
costa.voutsinas@muhc.mcgill.ca

PS. We still have a long way to go since
-the hospital neglected to build an air outlet (our pts enjoy 100% during the procedure)
-the powers that be don't want to pay for MR-compatible infusers so our head traumas have a (count the drops) Propofol +/- Levo drip instead of a safe, measured infusion.

Then again, it is better than bagging the patient vis-a-vis a 30ft. tubing and Ambu bag.

Resp Care 1991;36:1207-1210.

Kalaji,
Siemens, or Maquet, now, will never admit or deny compatability with their 900C in an MRI room. Reports from other facilities showed it works fine. I believe they put it onto another cart and removed the metal framed wheels.

BTW just saw what happens when an RN (thank God not an RT) carried an E cylinder into an MRI room. Thank God the patient was not on the table. They were in the process of dismantling the machine when I arrived to gawk. The tech told me the tank doesn't just fly off and adhere to the magnet, no, it ricochets back and forth until the kinetic energy dissipates, then it mates with the magnet. Not a pretty sight, I'm sure.

Jeff