Phenobarbital and neonatal seizures affect cerebral oxygen metabolism: a near-infrared spectroscopy study.
Phenobarbital and neonatal seizures affect cerebral oxygen metabolism: a near-infrared spectroscopy study.
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DOI：
10.1038/pr.2015.64
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发表时间：
2015-07
影响因子：
3.6
通讯作者：
Shellhaas, Renee A.
中科院分区：
文献类型：
--
作者：
Sokoloff, Max D.;Plegue, Melissa A.;Chervin, Ronald D.;Barks, John D. E.;Shellhaas, Renee A.
近红外光谱（NIRS）测量氧代谢，并越来越多地用于监测危重新生儿。在这一人群中的NIRS记录的数据的含义知之甚少。我们评估了NIRS监测新生儿癫痫发作。在视频脑电图监测的新生儿中，每5秒记录一次NIRS测量的脑局部氧饱和度（rSO 2）和全身氧饱和度。在苯巴比妥给药前、给药期间和给药后提取1小时区组的平均rSO 2。对于每次电描记癫痫发作，在发作模式之前和之后以及癫痫发作期间，提取平均rSO 2，持续时间为癫痫发作持续时间的3倍。开发了线性混合模型来评估苯巴比妥给药和癫痫发作对rSO 2和组织氧提取分数（FTOE）的影响。对20例新生儿（EGA 39.6±1.5周），61次苯巴比妥给药和40次癫痫发作进行了分析。随着苯巴比妥剂量的增加，大脑rSO 2升高（p=0.005），FTOE下降（p=0.018）。与基线和发作后阶段相比，癫痫发作期间rSO 2下降（基线81.2 vs.发作期77.7 vs.发作后79.4; p=0.004）。癫痫发作期间FTOE最高（p=0.002）。苯巴比妥给药后脑氧代谢降低，癫痫发作时氧代谢增加。脑氧代谢的这些微小但明显的变化值得评估潜在的临床影响。
Near-infrared spectroscopy (NIRS) measures oxygen metabolism and is increasingly used for monitoring critically-ill neonates. The implications of NIRS-recorded data in this population are poorly understood. We evaluated NIRS monitoring for neonates with seizures. In neonates monitored with video-EEG, NIRS-measured cerebral regional oxygen saturation (rSO2) and systemic O2 saturation were recorded every 5 seconds. Mean rSO2 was extracted for 1-hour blocks before, during, and after phenobarbital doses. For each electrographic seizure, mean rSO2 was extracted for a period of 3-times the duration of the seizure before and after the ictal pattern, and during the seizure. Linear mixed models were developed to assess the impact of phenobarbital administration and of seizures on rSO2 and fractional tissue oxygen extraction (FTOE). For 20 neonates (EGA 39.6±1.5 weeks), 61 phenobarbital doses and 40 seizures were analyzed. Cerebral rSO2 rose (p=0.005), and FTOE declined (p=0.018) with increasing phenobarbital doses. rSO2 declined during seizures, compared with baseline and post-ictal phases (baseline 81.2 vs. ictal 77.7 vs. post-ictal 79.4; p=0.004). FTOE was highest during seizures (p=0.002). Cerebral oxygen metabolism decreases after phenobarbital administration and increases during seizures. These small, but clear, changes in cerebral oxygen metabolism merit assessment for potential clinical impact.
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影响因子：
2.5
作者：
van der Heide, Mariska J.;Roze, Elise;Bos, Arend F.
通讯作者：
Bos, Arend F.
影响因子：
5.1
作者：
Glass, Hannah C.;Glidden, David;Jeremy, Rita J.;Barkovich, A. James;Ferriero, Donna M.;Miller, Steven P.
通讯作者：
Miller, Steven P.
影响因子：
3.6
作者：
Tsuji, M;Duplessis, A;Volpe, JJ
通讯作者：
Volpe, JJ
影响因子：
5.1
作者：
Glass, Hannah C.;Nash, Kendall B.;Cilio, Maria Roberta
通讯作者：
Cilio, Maria Roberta
DOI：
10.1136/fn.80.2.f105
发表时间：
1999-03-01
影响因子：
4.4
作者：
Boylan, GB;Panerai, RB;Binnie, CD
通讯作者：
Binnie, CD