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Lidocaine response ...
Lidocaine response rate in aEEG-confirmed neonatal seizures : Retrospective study of 413 full-term and preterm infants
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- Weeke, Lauren C. (author)
- Wilhelmina Childrens Hosp, Univ Med Ctr Utrecht, Dept Neonatol, Utrecht, Netherlands.
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- Toet, Mona C. (author)
- Wilhelmina Childrens Hosp, Univ Med Ctr Utrecht, Dept Neonatol, Utrecht, Netherlands.
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- van Rooij, Linda G. M. (author)
- Wilhelmina Childrens Hosp, Univ Med Ctr Utrecht, Dept Neonatol, Utrecht, Netherlands.
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- Groenendaal, Floris (author)
- Wilhelmina Childrens Hosp, Univ Med Ctr Utrecht, Dept Neonatol, Utrecht, Netherlands.
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- Boylan, Geraldine B. (author)
- Natl Univ Ireland Univ Coll Cork, Irish Ctr Fetal & Neonatal Translat Res, Cork, Ireland.
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- Pressler, Ronit M. (author)
- UCL, Inst Child Hlth, Sect Clin Neurosci, London, England.
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- Hellström-Westas, Lena (author)
- Uppsala universitet,Pediatrik
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- van den Broek, Marcel P. H. (author)
- Univ Med Ctr Utrecht, Dept Clin Pharm, Utrecht, Netherlands.
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- de Vries, Linda S. (author)
- Wilhelmina Childrens Hosp, Univ Med Ctr Utrecht, Dept Neonatol, Utrecht, Netherlands.
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Wilhelmina Childrens Hosp, Univ Med Ctr Utrecht, Dept Neonatol, Utrecht, Netherlands Natl Univ Ireland Univ Coll Cork, Irish Ctr Fetal & Neonatal Translat Res, Cork, Ireland. (creator_code:org_t)
- 2015-12-31
- 2016
- English.
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In: Epilepsia. - : Wiley. - 0013-9580 .- 1528-1167. ; 57:2, s. 233-242
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Subject headings
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- ObjectiveTo investigate the seizure response rate to lidocaine in a large cohort of infants who received lidocaine as second- or third-line antiepileptic drug (AED) for neonatal seizures. MethodsFull-term (n = 319) and preterm (n = 94) infants, who received lidocaine for neonatal seizures confirmed on amplitude-integrated EEG (aEEG), were studied retrospectively (January 1992-December 2012). Based on aEEG findings, the response was defined as good (>4 h no seizures, no need for rescue medication); intermediate (0-2 h no seizures, but rescue medication needed after 2-4 h); or no clear response (rescue medication needed <2 h). ResultsLidocaine had a good or intermediate effect in 71.4%. The response rate was significantly lower in preterm (55.3%) than in full-term infants (76.1%, p < 0.001). In full-term infants the response to lidocaine was significantly better than midazolam as second-line AED (21.4% vs. 12.7%, p = 0.049), and there was a trend for a higher response rate as third-line AED (67.6% vs. 57%, p = 0.086). Both lidocaine and midazolam had a higher response rate as third-line AED than as second-line AED (p < 0.001). Factors associated with a good response to lidocaine were the following: higher gestational age, longer time between start of first seizure and administration of lidocaine, lidocaine as third-line AED, use of new lidocaine regimens, diagnosis of stroke, use of digital aEEG, and hypothermia. Multivariable analysis of seizure response to lidocaine included lidocaine as second- or third-line AED and seizure etiology. SignificanceSeizure response to lidocaine was seen in similar to 70%. The response rate was influenced by gestational age, underlying etiology, and timing of administration. Lidocaine had a significantly higher response rate than midazolam as second-line AED, and there was a trend for a higher response rate as third-line AED. Both lidocaine and midazolam had a higher response rate as third-line compared to second-line AED, which could be due to a pharmacologic synergistic mechanism between the two drugs.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
Keyword
- Lidocaine
- Midazolam
- Response rate
- Antiepileptic drugs
- Neonatal seizures
Publication and Content Type
- ref (subject category)
- art (subject category)
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