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Detection of seizure activity in the paralyzed neonate using continuous monitoring.

Publication ,  Journal Article
Goldberg, RN; Goldman, SL; Ramsay, RE; Feller, R
Published in: Pediatrics
May 1982

In experimental animals neurologic damage may occur during seizure activity whether the seizure is accompanied by motor activity and hypoxemia or whether the animal is paralyzed and normoxemic. These findings suggest that it may be important to detect seizure activity in the paralyzed neonate. Nine infants who were mechanically ventilated and paralyzed with pancuronium had their condition diagnosed as seizure activity. Vital signs were continuously monitored and six infants had either oxygen saturation or transcutaneous oxygen measured during seizure activity. For the group as a whole, rhythmic fluctuations in vital signs, cardiac rhythm, and oxygenation occurred every four minutes (range one to seven minutes) and lasted two minutes (range one to four minutes). In seven patients whose seizures were not accompanied by cardiac arrhythmias the following mean increases were noted: systolic arterial blood pressure, 15 mm Hg (range 7 to 36 mm Hg); heart rate, ten beats per minute (-11 to 30/min); oxygen saturation, 12% (range 4% to 20%); and transcutaneous oxygen, 31 mm Hg (range 14 to 45 mm Hg). Seizures in the two patients with cardiac arrhythmias were accompanied by a decrease in systolic arterial blood pressure of 27 mm Hg (range 15 to 40 mm Hg) and in oxygen saturation of 24% (range 20% to 28%). The presence of rhythmic fluctuation in vital signs and oxygenation should alert the physician to the possibility of seizure activity in the paralyzed neonate.

Duke Scholars

Published In

Pediatrics

ISSN

0031-4005

Publication Date

May 1982

Volume

69

Issue

5

Start / End Page

583 / 586

Location

United States

Related Subject Headings

  • Seizures
  • Pediatrics
  • Pancuronium
  • Oxygen
  • Monitoring, Physiologic
  • Infant, Newborn, Diseases
  • Infant, Newborn
  • Humans
  • Electroencephalography
  • Electrocardiography
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Goldberg, R. N., Goldman, S. L., Ramsay, R. E., & Feller, R. (1982). Detection of seizure activity in the paralyzed neonate using continuous monitoring. Pediatrics, 69(5), 583–586.
Goldberg, R. N., S. L. Goldman, R. E. Ramsay, and R. Feller. “Detection of seizure activity in the paralyzed neonate using continuous monitoring.Pediatrics 69, no. 5 (May 1982): 583–86.
Goldberg RN, Goldman SL, Ramsay RE, Feller R. Detection of seizure activity in the paralyzed neonate using continuous monitoring. Pediatrics. 1982 May;69(5):583–6.
Goldberg, R. N., et al. “Detection of seizure activity in the paralyzed neonate using continuous monitoring.Pediatrics, vol. 69, no. 5, May 1982, pp. 583–86.
Goldberg RN, Goldman SL, Ramsay RE, Feller R. Detection of seizure activity in the paralyzed neonate using continuous monitoring. Pediatrics. 1982 May;69(5):583–586.

Published In

Pediatrics

ISSN

0031-4005

Publication Date

May 1982

Volume

69

Issue

5

Start / End Page

583 / 586

Location

United States

Related Subject Headings

  • Seizures
  • Pediatrics
  • Pancuronium
  • Oxygen
  • Monitoring, Physiologic
  • Infant, Newborn, Diseases
  • Infant, Newborn
  • Humans
  • Electroencephalography
  • Electrocardiography