Anesthesia, MRI, Renal Blood Flow, Renal Oxygenation
Conditions
Keywords
Renal Blood flow, Anesthesia, Pediatric, MRI
Brief summary
The goal of this study is to investigate the effect of the anesthetic agents sevoflurane or propofol on the blood flow and oxygen delivery to the kidneys. Pediatric patients who are planned to undergo an MRI scan with generalized anesthesia will be randomized to either IV anesthesia with propofol or inhalation anesthesia with sevoflurane. Both of these anesthetic methods are commonly used for anesthesia on an everyday basis. In addition to the clinically indicated MRI, Multiparametric MRI will be performed to visualize the effect of the anesthetic agent on renal blood flow, perfusion and oxygenation.
Detailed description
See the study protocol
Interventions
DRUGAnesthesia Maintenance Agent
Difference in renal blood flow (RBF) between Propofol and Sevoflurane groups. Quantified by specific Multiparametric MRI metrics (e.g., (Renal blood flow by phase contrast imaging) (regional perfusion by Arterial Spin labeling (ASL) and global and regional oxygenation by Blood oxygen dependent signal (BOLD))
Sponsors
Uppsala University Hospital
Uppsala University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
SINGLE (Outcomes Assessor)
Masking description
The analyzer of the MRI images of renal blood flow, quantifying volumes will be masked from the method of anesthesia.
Intervention model description
Patients are randomized to one out of two possible methods of maintenance anesthesia
Eligibility
Sex/Gender
ALL
Age
1 Months to 14 Years
Healthy volunteers
No
Inclusion criteria
* Pediatric Patients (1 month -14 years of age) * Indicated for MRI with anesthesia * ASA (American Society of Anesthesiologists) physical status I-III
Exclusion criteria
* Known renal impairment or chronic kidney disease * Severe cardiac or pulmonary disease * Allergy to either Propofol or Sevoflurane * Contraindications to Magnetic Resonance Imaging * Contraindications to either Propofol or Sevoflurane * Declined participation or declined consent from patients, parents or guardians * Ongoing acute kidney injury
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Differences in RBF, as measured by phase contrast imaging with mpMRI, between propofol and sevoflurane anesthesia. | The extra imaging is expected to take 20-30 minutes. | Multiparametric MRI via phase contrast imaging to quantify renal blood flow, will be standardized to renal area. By quantifying renal blood flow we will be able to evaluate the effects of propofol and sevoflurane on RBF. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Differences in regional renal tissue perfusion, as measured by arterial spin labelling (ASL) with mpMRI, between propofol and sevoflurane anaesthesia | The whole MpMRI will take around 20-30 minutes all together where the primary and secondary outcomes can later be extracted via analysis of the images | To investigate the effect of Propofol and Sevoflurane on regional tissue perfusion in the renal cortex and medulla. |
| Differences in regional and global renal oxygenation, as measured by Blood Oxygen Level Dependent (BOLD) signal via mpMRI, between propofol and sevoflurane anaesthesia. | The whole MpMRI will take around 20-30 minutes all together where the primary and secondary outcomes can later be extracted via analysis of the images | To explore potential differences related to the Sevoflurane or Propofol on regional and global renal oxygenation. |
| The difference in relation of RBF to systemic non-invasive blood pressure, between propofol and sevoflurane anaesthesia | The entire MpMRI will take around 20-30 minutes all together where the primary and secondary outcomes can later be extracted via analysis of the images | To investigate how RBF varies in relation to systemic blood pressure in paediatric patients in generalized anaesthesia with propofol or Sevoflurane. |
| The difference plasma renin concentration, measured by a blood sample, between propofol and sevoflurane anaesthesia | 1 minute | To explore the effect of Sevoflurane and Propofol on serum Renin concentration as a surrogate marker for Renal sympathetic nerve activation. |
Contacts
Primary ContactArash Emami, PhD student
Backup ContactRobert Frithiof, Professor
Outcome results
None listed