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Lidocaine response ...
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Weeke, Lauren C.Wilhelmina Childrens Hosp, Univ Med Ctr Utrecht, Dept Neonatol, Utrecht, Netherlands.
(författare)
Lidocaine response rate in aEEG-confirmed neonatal seizures : Retrospective study of 413 full-term and preterm infants
- Artikel/kapitelEngelska2016
Förlag, utgivningsår, omfång ...
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2015-12-31
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Wiley,2016
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printrdacarrier
Nummerbeteckningar
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LIBRIS-ID:oai:DiVA.org:uu-281839
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-281839URI
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https://doi.org/10.1111/epi.13286DOI
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Språk:engelska
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Sammanfattning på:engelska
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Ämneskategori:ref swepub-contenttype
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Ämneskategori:art swepub-publicationtype
Anmärkningar
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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.
Ämnesord och genrebeteckningar
Biuppslag (personer, institutioner, konferenser, titlar ...)
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Toet, Mona C.Wilhelmina Childrens Hosp, Univ Med Ctr Utrecht, Dept Neonatol, Utrecht, Netherlands.
(författare)
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van Rooij, Linda G. M.Wilhelmina Childrens Hosp, Univ Med Ctr Utrecht, Dept Neonatol, Utrecht, Netherlands.
(författare)
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Groenendaal, FlorisWilhelmina Childrens Hosp, Univ Med Ctr Utrecht, Dept Neonatol, Utrecht, Netherlands.
(författare)
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Boylan, Geraldine B.Natl Univ Ireland Univ Coll Cork, Irish Ctr Fetal & Neonatal Translat Res, Cork, Ireland.
(författare)
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Pressler, Ronit M.UCL, Inst Child Hlth, Sect Clin Neurosci, London, England.
(författare)
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Hellström-Westas, LenaUppsala universitet,Pediatrik(Swepub:uu)lenwe671
(författare)
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van den Broek, Marcel P. H.Univ Med Ctr Utrecht, Dept Clin Pharm, Utrecht, Netherlands.
(författare)
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de Vries, Linda S.Wilhelmina Childrens Hosp, Univ Med Ctr Utrecht, Dept Neonatol, Utrecht, Netherlands.
(författare)
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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)
Sammanhörande titlar
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Ingår i:Epilepsia: Wiley57:2, s. 233-2420013-95801528-1167
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