Respiratory Variability Predicts Hypoxemia After Generalized Convulsive Seizures
Abstract number :
3.077
Submission category :
2. Translational Research / 2A. Human Studies
Year :
2021
Submission ID :
1826152
Source :
www.aesnet.org
Presentation date :
12/6/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:52 AM
Authors :
Rup Sainju, MD - University of Iowa Hospitals and Clinics; Deidre Dragon - Neurology - University of Iowa Hospitals and Clinics; Harold Winnike, RRT - Institute of Clinical and Translational Science - University of Iowa; Laura Vilella, MD - Neurology - University of Texas Health Science Center at Houston; Xiaojin Li - Neurology - University of Texas Health Science Center at Houston; Samden Lhatoo, MD - Neurology - University of Texas Health Science Center at Houston; Patrick Ten Eyck - Institute of Clinical and Translational Science - University of Iowa; chaorong Wu - Institute of Clinical and Translational Science - University of Iowa; George Richerson, MD, PhD - Neurology, Molecular Physiology and Biophysics - University of Iowa Hospitals and Clinics; Brian Gehlbach, MD - Internal Medicine - University of Iowa Hospitals and Clinics
Rationale: Increasing evidence from both animal and human studies suggests severe respiratory dysfunction induced by generalized convulsive seizures (GCS) is the primary pathological mechanism of death in many SUDEP cases. Therefore, it has been proposed that severe periictal respiratory abnormality may be a potential biomarker for SUDEP risk. In mouse models of SUDEP, increased baseline respiratory variability during wakefulness has been reported in mice that later die of respiratory arrest after GCS. We studied respiratory variability at baseline and after GCS and its utility in predicting severity of periictal hypoxemia.
Methods: This is a retrospective study evaluating epilepsy patients age >18 yrs in the epilepsy monitoring unit with video EEG and cardio-respiratory monitoring using EKG, chest and abdominal belts to measure respiratory effort, nasal airflow, oro-nasal thermistor, and capillary pulse oximetry.
Clinical variables analyzed included age, gender, duration and type of epilepsy, BMI, active SSRI/SNRI use, and antiseizure medicines. Seizure related variables included durations of seizures, convulsive and tonic phases, post-ictal generalized EEG suppression (PGES), and post-ictal immobility (PI).
Respiratory variability was expressed as coefficient of variation of inter-breath-interval. Primary outcome was severity of periictal oxygen desaturation expressed as: a) nadir of capillary oxygen saturation (SaO2) and, b) duration of oxygen desaturation (time from SaO2 < 90% to > 90%).
Spearman’s correlation for continuous and student’s t-test for categorical variables were used to determine if their relationship with primary outcome. Variables with p<
Translational Research