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Cerebral oximetry monitoring in pediatric seizure patients in the emergency department
Critical Care volume 19, Article number: P459 (2015)
During ictal/post-ictal events, altered cerebral physiology occurs: increased neuronal activity causes significant increase in cerebral metabolism with changes in ipsilateral cerebral blood flow. Standard PED seizure monitoring is by O2SAT and ETCO2 which yield no direct data about regional cerebral oxygenation/physiology (rSO2). Significant abnormal hemispheric cerebral physiology resulting in neurological injury can occur without knowing because the current monitoring system could not detect the abnormal hemispheric abnormality. Cerebral oximetry can provide a rapid, non-invasive detection of each hemisphere's cerebral physiologic changes during ictal/post-ictal phases. The aim was to study left and right rSO2 values in patients in the pre and post seizure periods and in nonseizing controls.
An observational study of seizing and nonseizing patient's left and right rSO2 readings compared with nonseizure patients.
No difference for ictal left and right rSO2 readings across ages. See Figure 1.
We have demonstrated abnormal hemispheric cerebral physiology during focal or generalized ictal activity. In patients with generalized seizures, the left and right rSO2 values were significantly decreased. In patients with focal seizures, the ipsilateral rSO2 values were significantly different from the contralateral rSO2 readings and correlated to the hemisphere experiencing the focal seizure. In certain patients, during the ictal phase their rSO2 readings rose and stayed or rose then dropped. Overall, cerebral oximetry has shown great monitoring potential for actively seizing patients in the emergency department.
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Abramo, T., Schnieder, B., Storm, E. et al. Cerebral oximetry monitoring in pediatric seizure patients in the emergency department. Crit Care 19, P459 (2015). https://doi.org/10.1186/cc14539
- Focal Seizure
- Monitoring Potential
- Cerebral Oximetry
- Seizure Patient
- Great Monitoring