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Cooling and seizure burden in term neonates: an observational study.
MedLine Citation:
PMID:  22215799     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
ObjectiveTo investigate any possible effect of cooling on seizure burden, the authors quantified the recorded electrographic seizure burden based on multichannel video-EEG recordings in term neonates with hypoxic-ischaemic encephalopathy (HIE) who received cooling and in those who did not.Study designRetrospective observational study.PatientsNeonates >37 weeks gestation born between 2003 and 2010 in two hospitals.MethodsOff-line analysis of prolonged continuous multichannel video-EEG recordings was performed independently by two experienced encephalographers. Comparison between the recorded electrographic seizure burden in non-cooled and cooled neonates was assessed. Data were treated as non-parametric and expressed as medians with interquartile ranges (IQR).ResultsOne hundred and seven neonates with HIE underwent prolonged continuous multichannel EEG monitoring. Thirty-seven neonates had electrographic seizures, of whom 31 had EEG recordings that were suitable for the analysis (16 non-cooled and 15 cooled). Compared with non-cooled neonates, multichannel EEG monitoring commenced at an earlier postnatal age in cooled neonates (6 (3-9) vs 15 (5-20) h)and continued for longer (88 (75-101) vs 55 (41-60) h). Despite this increased opportunity to capture seizures in cooled neonates, the recorded electrographic seizure burden in the cooled group was significantly lower than in the non-cooled group (60 (39-224) vs 203 (141-406) min). Further exploratory analysis showed that the recorded electrographic seizure burden was only significantly reduced in cooled neonates with moderate HIE (49 (26-89) vs 162 (97-262) min).ConclusionsA decreased seizure burden was seen in neonates with moderate HIE who received cooling. This finding may explain some of the therapeutic benefits of cooling seen in term neonates with moderate HIE.
Authors:
Evonne Low; Geraldine B Boylan; Sean R Mathieson; Deirdre M Murray; Irina Korotchikova; Nathan J Stevenson; Vicki Livingstone; Janet M Rennie
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-3
Journal Detail:
Title:  Archives of disease in childhood. Fetal and neonatal edition     Volume:  -     ISSN:  1468-2052     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1Neonatal Brain Research Group, Department of Paediatrics and Child Health, University College Cork, Cork, Ireland.
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