Division of Neonatology, Department of Pediatrics, University of Iowa Stead Family Children's Hospital, Iowa City, IA.
Division of Newborn Medicine, Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, MO.
J Pediatr. 2023 Jun;257:113348. doi: 10.1016/j.jpeds.2022.12.044. Epub 2023 Feb 16.
To determine the incidence of seizure-like events in a cohort of infants born preterm as well as the prevalence of associated vital sign changes (heart rate [HR], respiratory rate, and pulse oximetry [SpO]).
We performed prospective conventional video electroencephalogram monitoring on infants born at 23-30 weeks of gestational age during the first 4 postnatal days. For detected seizure-like events, simultaneously captured vital sign data were analyzed during the pre-event baseline and during the event. Significant vital sign changes were defined as HR or respiratory rate >±2 SD from the infant's own baseline physiologic mean, derived from a 10-minute interval before the seizure-like event. Significant change in SpO was defined as oxygen desaturation during the event with a mean SpO <88%.
Our sample included 48 infants with median gestational age of 28 weeks (IQR 26-29) and birth weight of 1125 g (IQR 963-1265). Twelve (25%) infants had seizure-like discharges with a total of 201 events; 83% (10/12) of infants had vital sign changes during these events, and 50% (6/12) had significant vital sign changes during the majority of the seizure-like events. Concurrent HR changes occurred the most frequently.
Individual infant variability was observed in the prevalence of concurrent vital sign changes with electroencephalographic seizure-like events. Physiologic changes associated with preterm electrographic seizure-like events should be investigated further as a potential biomarker to assess the clinical significance of such events in the preterm population.
确定早产儿队列中癫痫样发作事件的发生率，以及相关生命体征变化（心率[HR]、呼吸频率和脉搏血氧饱和度[SpO]）的患病率。
我们对 23-30 孕周出生的婴儿在出生后第 4 天内进行了前瞻性常规视频脑电图监测。对于检测到的癫痫样事件，同时分析了事件前基线和事件期间的同时捕获的生命体征数据。显著的生命体征变化定义为 HR 或呼吸频率比婴儿自身基线生理平均值高出或低于 2 个标准差，该平均值是在癫痫样事件发生前 10 分钟间隔内得出的。SpO 的显著变化定义为事件期间的氧饱和度下降，平均 SpO <88%。
我们的样本包括 48 名中位胎龄为 28 周（IQR 26-29）和出生体重为 1125g（IQR 963-1265）的婴儿。12 名（25%）婴儿有癫痫样放电，共有 201 次事件；83%（10/12）的婴儿在这些事件中有生命体征变化，50%（6/12）的婴儿在大多数癫痫样事件中有显著的生命体征变化。同时发生的 HR 变化最常见。
在与脑电图癫痫样事件同时发生的生命体征变化的患病率方面，观察到了个体婴儿的差异。与早产儿电生理癫痫样事件相关的生理变化应进一步研究，作为评估此类事件在早产儿人群中临床意义的潜在生物标志物。
