Electrographic neonatal seizures after infant heart surgery
Electrographic neonatal seizures after infant heart surgery
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DOI：
10.1111/j.0013-9580.2005.22504.x
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发表时间：
2005-01-01
期刊：
影响因子：
5.6
通讯作者：
Gaynor, TW
中科院分区：
文献类型：
--
作者：
Clancy, RR;Sharif, T;Gaynor, TW
目的：新生儿癫痫相对常见，是婴儿心脏手术后存活者急性脑病的重要早期体征。在这种情况下，癫痫发作的当代发生率尚不完全清楚，其电图特征也没有完全描述。本研究描述了当代先天性心脏病（CHD）婴儿的电描记新生儿癫痫发作（ENS）的特征，这些婴儿通过使用心肺转流手术修复，伴或不伴深低温停循环。对接受心脏手术的新生儿进行术后48 h的视频脑电图监测，以确定首次癫痫发作的时间，ENS总数，结果：183例新生儿中21例（11.5%）发生ENS。无临床可见的癫痫发作。至首次ENS的平均时间为21 h（范围：10-36 h）。整个队列中的ENS总数为1，429。48小时内每例患者的平均ENS总数为72（范围：1-217）。在12名受试者中，有5名（41.7%）的苯巴比妥给药与癫痫发作计数减少> 50%相关。结论：在婴儿心脏手术后的大型当代婴儿队列中，ENS相对常见。注意到癫痫发作负担的变化很大，但许多人经历了多次癫痫发作。新生儿癫痫电图是未来在该患者人群中进行神经保护试验的候选结局终点。
Purpose: Neonatal seizures are relatively common and an important early sign of acute encephalopathy in those who survive infant heart surgery. The contemporary occurrence of seizures in this setting is not fully known, and their electrographic characteristics are incompletely described. This study describes the characteristics of electrographic neonatal seizures (ENSs) in contemporary infants with congenital heart disease (CHD) surgically repaired by using cardiopulmonary bypass, with or without deep hypothermic circulatory arrest.Methods: Consecutive infants undergoing heart surgery were monitored by video-EEG for 48 h postoperatively to establish the time of first seizure, total number of ENSs,site(s) of ENS(s) origin and other characteristics.Results: ENSs occurred in 21 (11.5 %) of 183 infants. None had clinically visible seizures. The mean time to the first ENS was 21 h (range, 10-36 h). The total number of ENSs among the entire cohort was 1,429. Mean total number of ENSs per patient over a 48-h period was 72 (range, 1-217). Phenobarbital administration was associated with a > 50 % reduction in seizure counts in five (41.7 %) of 12 subjects.Conclusions: ENSs were relatively common in a large, contemporary cohort of infants after infant heart surgery. A wide variation was noted in seizure burden, but many experienced numerous seizures. Electrographic neonatal seizures are a candidate outcome end point in future neuroprotection trials in this patient population.