Pediatric Research ( IF 3.1 ) Pub Date : 2024-02-16 , DOI: 10.1038/s41390-024-03063-0 David Wertheim 1 , Anup C Kage 2, 3 , Ivone Lancoma-Malcolm 2 , Caroline Francia 2 , Michael Yoong 3, 4 , Divyen K Shah 2, 3
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Background
Effective seizure detection is important however, clinical signs of seizure activity may be subtle in neonates. This study aimed to systematically investigate SpO2 and respiratory pattern changes associated with EEG seizures in term-born neonates.
Method
An observational study in term neonates at risk of seizures admitted to a single tertiary level neonatal intensive care unit. Synchronised high-resolution physiological data (ECG, pulse oximetry, respiration) and EEG/amplitude-integrated EEG (aEEG) monitoring were recorded. Sections of traces with evidence of clear EEG seizure activity were compared with physiological data recorded at the same time.
Results
22/44 (50%) neonates who had aEEG monitoring were noted to have electrographic seizures. Physiologic download measurements were available for 11 of these neonates. In nine of these, an acute drop in oxygen saturation (SpO2) of at least 5% was noted in at least one seizure. Accompanying apnoeas were noted in three neonates.
Conclusion
Acute decreases in SpO2 were seen in term neonates associated with seizures and these were not always accompanied by an apnoeic episode. Physiologic download in association with EEG monitoring may assist in improving seizure detection. Unexplained drops in SpO2 could indicate further investigation for possible seizures in at-risk neonates.
Impact
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A decrease in blood oxygen saturation (SpO2) associated with EEG seizures can occur in term infants with HIE or perinatal stroke.
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Drops in SpO2 associated with EEG seizures in term infants with HIE or stroke may occur in the absence of apnoeas.
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Unexplained acute falls in SpO2 in sick neonates may suggest possible seizures.
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Drops in SpO2 associated with seizures in term infants can occur over less than 3 minutes.
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Physiological monitoring alongside EEG monitoring could help to improve seizure detection.
中文翻译：
足月新生儿血氧饱和度下降伴随电图癫痫发作：一项观察性研究
背景
有效的癫痫发作检测很重要，然而，新生儿癫痫发作活动的临床症状可能很微妙。本研究旨在系统地研究足月新生儿的 SpO 2和呼吸模式变化与脑电图癫痫发作相关。
方法
一项针对入住三级新生儿重症监护病房的有癫痫风险的足月新生儿的观察性研究。记录同步高分辨率生理数据（心电图、脉搏血氧饱和度、呼吸）和脑电图/振幅积分脑电图（aEEG）监测。将具有明显脑电图癫痫发作活动证据的痕迹部分与同时记录的生理数据进行比较。
结果
22/44 (50%) 进行 aEEG 监测的新生儿被发现有电图癫痫发作。其中 11 名新生儿的生理下载测量结果可用。其中 9 例中，至少有一次癫痫发作时血氧饱和度 (SpO 2 ) 急剧下降至少 5%。三名新生儿伴有呼吸暂停。
结论
足月新生儿中观察到 SpO 2急剧下降，并伴有癫痫发作，但这些情况并不总是伴有呼吸暂停发作。与脑电图监测相关的生理下载可能有助于改善癫痫发作检测。不明原因的 SpO 2下降可能表明需要进一步调查高危新生儿可能发生的癫痫发作。
影响
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患有 HIE 或围产期卒中的足月儿可能会出现与脑电图癫痫发作相关的血氧饱和度 (SpO 2 ) 降低。 -
患有 HIE 或中风的足月儿，在没有呼吸暂停的情况下，可能会出现与 EEG 癫痫发作相关的 SpO 2下降。 -
患病新生儿不明原因的 SpO 2急剧下降可能提示可能出现癫痫发作。 -
与足月婴儿癫痫发作相关的 SpO 2下降可能会在不到 3 分钟的时间内发生。 -
生理监测和脑电图监测有助于改善癫痫发作的检测。
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