Cerebral oxygenation during subclinical seizures in neonatal hypoxic-ischaemic encephalopathy

Preterm Infants Exhibit Greater Variability in Cerebrovascular Control than Term Infants

“…Studies in both humans and animals suggest that cerebral hypoxic damage occurs with cerebral oxygenation levels below 40%. 30,31 Preterm infants with a baseline cerebral TOI of approximately 50% are dangerously close to pathologically impaired cerebral oxygenation in the prone position at 2-3 mo CA. Thus, although the percentage increase in cerebral TOI in response to a HUT may be greater in preterm infants at 2-3 mo in QS in the prone position, this increase remains insufficient to overcome the baseline deficit in cerebral TOI in preterm compared to term infants as highlighted in Figure 5; thus, absolute cerebral TOI remains lower in the preterm cohort during a HUT.…”

Hemispheric Cerebral Oximetry Monitoring During Pediatric Seizure Activity in a Pediatric Emergency Department

“… 16 – 20 , 24 – 27 In the generalized and focal seizure patients, during the seizure phase, there were 2 trends noted during the seizure phase: r c SO 2 readings of less than 60 or greater than 80%, and with seizures with greater than 80% readings decreasing over time. 16 – 20 , 24 – 27 In either left or right focal seizure, hemispheric r c SO 2 readings had a strong correlation to the seizure side with a wide interhemispheric discordance r c SO 2 . As in similar cerebral oximetry studies, these focal and general seizures' r c SO 2 reading changes demonstrate that nonfrontal hemispheric abnormal regional cerebral activity has a dynamic interplay with and can affect the frontal hemispheric cerebral physiology.…”

Phenobarbital and neonatal seizures affect cerebral oxygen metabolism: a near-infrared spectroscopy study

“…For a 39 week male infant with hypoxic ischemic encephalopathy treated with phenobarbital and phenytoin, prolonged (>7 minute) subclinical seizures were associated with decreased cerebral tissue oxygenation index (analogous to rSO 2 ) (14). This was similar to our finding of lower cerebral rSO 2 values during seizures.…”

“…Recently, additional cerebral monitoring has been advocated. Among clinically-available non-invasive devices, near-infrared spectroscopy (NIRS) has been suggested as a potentially helpful instrument for monitoring brain functional integrity (13, 14). Disturbances in cerebral oxygen metabolism and blood flow, measured by transcranial doppler, have been linked to electrographic seizures (15, 16).…”