Photo Credit: Artemis Diana
The following is a summary of “Remote Monitoring for Seizures During Therapeutic Hypothermia in Neonates With Hypoxic-Ischemic Encephalopathy,” published in the November 2023 issue of Pediatrics by Variane et al.
For a study, researchers focused on neonates suffering from hypoxic-ischemic encephalopathy (HIE) and undergoing therapeutic hypothermia (TH). Their objective was to closely examine the occurrence, management, and progression of seizures in these newborns through a telehealth-based model and remote neuromonitoring.
This prospective and observational multicenter cohort study aimed to show how promptly identifying and reducing seizure activity during TH might influence neurological and neurodevelopmental outcomes in this vulnerable population. The data analysis took place between November 2022 and April 2023.
The study involved 872 cooled newborns, and researchers found significant correlations between electrographic seizures and certain neurological indicators. Around 33.9% of the infants experienced electrographic seizures, with 71.9% having exclusively electrographic activity. Abnormal early background activity demonstrated a clear association with seizures, notably flat trace showing the highest seizure rate (68.2%) and a considerable likelihood of seizure incidence (odds ratio [OR], 12.90; 95% CI, 7.57-22.22) compared to continuous normal voltage. Additionally, the absence of sleep-wake cycling was linked to a higher seizure occurrence (OR, 2.22; 95% CI, 1.67-2.96). Seizures were most frequent between 6 and 24 hours after birth (61.1%); however, 11.5% of infants experienced seizures during rewarming. For treatment, a single antiepileptic drug controlled seizures in 64.9% of cases, with phenobarbital being the primary medication used (99.3%).
The study found that 33.9% of HIE-treated newborns had electrographic seizures, controlled with one drug in 64.9%, supporting remote neurocritical care possibilities.
Source: jamanetwork.com/journals/jamanetworkopen/fullarticle/2811869
