Electroencephalogram changes during inhalation with nitric oxide in the pediatric intensive care patient--a preliminary report.

Details

Serval ID
serval:BIB_39C95DB89383
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Electroencephalogram changes during inhalation with nitric oxide in the pediatric intensive care patient--a preliminary report.
Journal
Critical Care Medicine
Author(s)
Moenkhoff M., Schmitt B., Wohlrab G., Waldvogel K., Fanconi S., Baenziger O.
ISSN
0090-3493 (Print)
ISSN-L
0090-3493
Publication state
Published
Issued date
1998
Peer-reviewed
Oui
Volume
26
Number
11
Pages
1887-1892
Language
english
Notes
Publication types: Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
OBJECTIVES: Although endogenous nitric oxide (NO) is an excitatory mediator in the central nervous system, inhaled NO is not considered to cause neurologic side effects because of its short half-life. This study was motivated by a recent case report about neurologic symptoms and our own observation of severe electroencephalogram (EEG) abnormalities during NO inhalation.
DESIGN: Blind, retrospective analyses of EEGs which were registered before, during, and after NO inhalation. EEG was classified in a 5-point rating system by an independent electroencephalographer who was blinded to the patients' clinical histories. Comparisons were made with the previous evaluation documented at recording. Other EEG-influencing parameters such as oxygen saturation, hemodynamics, electrolytes, and pH were evaluated.
SETTING: Pediatric intensive care unit of a tertiary care university children's hospital.
PATIENTS: Eleven ventilated, long-term paralyzed, sedated children (1 mo to 14 yrs) who had EEG or clinical assessment before NO treatment and EEG during NO inhalation. They were divided into two groups according to the NO-indication (e.g., congenital heart defect, acute respiratory distress syndrome).
MEASUREMENTS AND MAIN RESULTS: All 11 patients had an abnormal EEG during NO inhalation. EEG-controls without NO showed remarkable improvement. EEG abnormalities were background slowing, low voltage, suppression burst (n = 2), and sharp waves (n = 2) independent of patients' age, NO-indication, and other EEG-influencing parameters.
CONCLUSIONS: These preliminary data suggest the occurrence of EEG-abnormalities after application of inhaled NO in critically ill children. We found no correlation with other potential EEG-influencing parameters, although clinical state, medication, or hypoxemia might contribute. Comprehensive, prospective, clinical assessment regarding a causal relationship between NO-inhalation and EEG-abnormalities and their clinical importance is needed.
Keywords
Administration, Inhalation, Adolescent, Child, Child, Preschool, Electroencephalography/drug effects, Electroencephalography/statistics & numerical data, Heart Defects, Congenital/drug therapy, Heart Defects, Congenital/physiopathology, Humans, Infant, Intensive Care Units, Pediatric, Nitric Oxide/administration & dosage, Nitric Oxide/adverse effects, Respiratory Distress Syndrome, Adult/drug therapy, Respiratory Distress Syndrome, Adult/physiopathology, Retrospective Studies, Vasodilator Agents/administration & dosage, Vasodilator Agents/adverse effects
Pubmed
Web of science
Create date
25/01/2008 10:06
Last modification date
20/08/2019 13:29
Usage data