Suppression of Electrographic Seizures Is Associated with Amelioration of QTc Interval Prolongation in Patients with Traumatic Brain Injury
Introduction: Disorders in electroencephalography (EEG) are commonly noted in patients with traumatic brain injury (TBI) and may be associated with electrocardiographic disturbances. Electrographic seizures (ESz) are the most common features in these patients. This study aimed to explore the relatio...
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| Veröffentlicht in: | JOURNAL OF CLINICAL MEDICINE 2021-11, Vol.10 (22), p.5374, Article 5374 |
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| description | Introduction: Disorders in electroencephalography (EEG) are commonly noted in patients with traumatic brain injury (TBI) and may be associated with electrocardiographic disturbances. Electrographic seizures (ESz) are the most common features in these patients. This study aimed to explore the relationship between ESz and possible changes in QTc interval and spatial QRS-T angle both during ESz and after ESz resolution. Methods: Adult patients with TBI were studied. Surface 12-lead ECGs were recorded using a Cardiax device during ESz events and 15 min after their effective suppression using barbiturate infusion. The ESz events were diagnosed using Masimo Root or bispectral index (BIS) devices. Results: Of the 348 patients considered for possible inclusion, ESz were noted in 72, with ECG being recorded in 21. Prolonged QTc was noted during ESz but significantly ameliorated after ESz suppression (540.19 & PLUSMN; 60.68 ms vs. 478.67 & PLUSMN; 38.52 ms, p < 0.001). The spatial QRS-T angle was comparable during ESz and after treatment. Regional cerebral oximetry increased following ESz suppression (from 58.4% & PLUSMN; 6.2 to 60.5% & PLUSMN; 4.2 (p < 0.01) and from 58.2% & PLUSMN; 7.2 to 60.8% & PLUSMN; 4.8 (p < 0.05) in the left and right hemispheres, respectively). Conclusion: QTc interval prolongation occurs during ESz events in TBI patients but both it and regional cerebral oximetry are improved after suppression of seizures. |
| doi_str_mv | 10.3390/jcm10225374 |
| format | Article |
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Electrographic seizures (ESz) are the most common features in these patients. This study aimed to explore the relationship between ESz and possible changes in QTc interval and spatial QRS-T angle both during ESz and after ESz resolution. Methods: Adult patients with TBI were studied. Surface 12-lead ECGs were recorded using a Cardiax device during ESz events and 15 min after their effective suppression using barbiturate infusion. The ESz events were diagnosed using Masimo Root or bispectral index (BIS) devices. Results: Of the 348 patients considered for possible inclusion, ESz were noted in 72, with ECG being recorded in 21. Prolonged QTc was noted during ESz but significantly ameliorated after ESz suppression (540.19 & PLUSMN; 60.68 ms vs. 478.67 & PLUSMN; 38.52 ms, p < 0.001). The spatial QRS-T angle was comparable during ESz and after treatment. Regional cerebral oximetry increased following ESz suppression (from 58.4% & PLUSMN; 6.2 to 60.5% & PLUSMN; 4.2 (p < 0.01) and from 58.2% & PLUSMN; 7.2 to 60.8% & PLUSMN; 4.8 (p < 0.05) in the left and right hemispheres, respectively). Conclusion: QTc interval prolongation occurs during ESz events in TBI patients but both it and regional cerebral oximetry are improved after suppression of seizures.]]></description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm10225374</identifier><identifier>PMID: 34830656</identifier><language>eng</language><publisher>BASEL: Mdpi</publisher><subject>Anesthesia ; Clinical medicine ; Convulsions & seizures ; Electroencephalography ; Fentanyl ; General & Internal Medicine ; Intensive care ; Life Sciences & Biomedicine ; Medicin och hälsovetenskap ; Medicine, General & Internal ; Metabolism ; Potassium ; Science & Technology ; Traumatic brain injury</subject><ispartof>JOURNAL OF CLINICAL MEDICINE, 2021-11, Vol.10 (22), p.5374, Article 5374</ispartof><rights>2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 by the authors. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>1</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000725262900001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c474t-9ff214647e5329ae897fe6782e48d3682e9e5132083d44748846711578268ee73</citedby><cites>FETCH-LOGICAL-c474t-9ff214647e5329ae897fe6782e48d3682e9e5132083d44748846711578268ee73</cites><orcidid>0000-0002-1001-0080 ; 0000-0003-1997-3227 ; 0000-0001-8194-1723 ; 0000-0003-0449-2375 ; 0000-0001-7017-0150 ; 0000-0002-2193-1512</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8622115/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8622115/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,553,728,781,785,886,27929,27930,39263,53796,53798</link.rule.ids><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:148339594$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Dabrowski, Wojciech</creatorcontrib><creatorcontrib>Siwicka-Gieroba, Dorota</creatorcontrib><creatorcontrib>Schlegel, Todd T.</creatorcontrib><creatorcontrib>Robba, Chiara</creatorcontrib><creatorcontrib>Zaid, Sami</creatorcontrib><creatorcontrib>Bielacz, Magdalena</creatorcontrib><creatorcontrib>Jaroszynski, Andrzej</creatorcontrib><creatorcontrib>Badenes, Rafael</creatorcontrib><title>Suppression of Electrographic Seizures Is Associated with Amelioration of QTc Interval Prolongation in Patients with Traumatic Brain Injury</title><title>JOURNAL OF CLINICAL MEDICINE</title><addtitle>J CLIN MED</addtitle><description><![CDATA[Introduction: Disorders in electroencephalography (EEG) are commonly noted in patients with traumatic brain injury (TBI) and may be associated with electrocardiographic disturbances. Electrographic seizures (ESz) are the most common features in these patients. This study aimed to explore the relationship between ESz and possible changes in QTc interval and spatial QRS-T angle both during ESz and after ESz resolution. Methods: Adult patients with TBI were studied. Surface 12-lead ECGs were recorded using a Cardiax device during ESz events and 15 min after their effective suppression using barbiturate infusion. The ESz events were diagnosed using Masimo Root or bispectral index (BIS) devices. Results: Of the 348 patients considered for possible inclusion, ESz were noted in 72, with ECG being recorded in 21. Prolonged QTc was noted during ESz but significantly ameliorated after ESz suppression (540.19 & PLUSMN; 60.68 ms vs. 478.67 & PLUSMN; 38.52 ms, p < 0.001). The spatial QRS-T angle was comparable during ESz and after treatment. Regional cerebral oximetry increased following ESz suppression (from 58.4% & PLUSMN; 6.2 to 60.5% & PLUSMN; 4.2 (p < 0.01) and from 58.2% & PLUSMN; 7.2 to 60.8% & PLUSMN; 4.8 (p < 0.05) in the left and right hemispheres, respectively). Conclusion: QTc interval prolongation occurs during ESz events in TBI patients but both it and regional cerebral oximetry are improved after suppression of seizures.]]></description><subject>Anesthesia</subject><subject>Clinical medicine</subject><subject>Convulsions & seizures</subject><subject>Electroencephalography</subject><subject>Fentanyl</subject><subject>General & Internal Medicine</subject><subject>Intensive care</subject><subject>Life Sciences & Biomedicine</subject><subject>Medicin och hälsovetenskap</subject><subject>Medicine, General & Internal</subject><subject>Metabolism</subject><subject>Potassium</subject><subject>Science & Technology</subject><subject>Traumatic brain injury</subject><issn>2077-0383</issn><issn>2077-0383</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>HGBXW</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>D8T</sourceid><recordid>eNqNks1u1DAQgCMEolXpiRewxAUJBfyX2LkgLasWVqpEUZdz5DqTXS9JHOykq_IKvDQTsvQHCYlcPPJ838QeT5K8ZPStEAV9t7Mto5xnQsknyTGnSqVUaPH0QXyUnMa4o_hpLTlTz5MjIbWgeZYfJz-vxr4PEKPzHfE1OWvADsFvgum3zpIrcD9GTJNVJIsYvXVmgIrs3bAlixYa54MZDuqXtSWrboBwYxpyGXzju82cdB25xAi6Ic7qOpixxR1LPgSD2VW3G8Pti-RZbZoIp4f1JPl6frZefkovPn9cLRcXqZVKDmlR15zJXCrIBC8M6ELVkCvNQepK5LgWkDHBqRaVRANvnSvGMiRyDaDESZLOdeMe-vG67INrTbgtvXHlYesbRlDKTAk-8cU_-T746l76IzLsryiyQqL7fnYRaKGy2INgmsclHmU6ty03_qbUOed4aCzw-lAg-O8jxKFsXbTQNKYDP8aS51RSVuhMIPrqL3Tnx9BhKycK-8FENt3mzUzZ4GMMUN8dhtFymqnywUwhrWd6D9e-jhYf0cKdgTOleMZzXkzjxZZu-P3gSz92w_2P_kcVvwAFjeCH</recordid><startdate>20211118</startdate><enddate>20211118</enddate><creator>Dabrowski, Wojciech</creator><creator>Siwicka-Gieroba, Dorota</creator><creator>Schlegel, Todd T.</creator><creator>Robba, Chiara</creator><creator>Zaid, Sami</creator><creator>Bielacz, Magdalena</creator><creator>Jaroszynski, Andrzej</creator><creator>Badenes, Rafael</creator><general>Mdpi</general><general>MDPI AG</general><general>MDPI</general><scope>BLEPL</scope><scope>DTL</scope><scope>HGBXW</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D8T</scope><scope>ZZAVC</scope><orcidid>https://orcid.org/0000-0002-1001-0080</orcidid><orcidid>https://orcid.org/0000-0003-1997-3227</orcidid><orcidid>https://orcid.org/0000-0001-8194-1723</orcidid><orcidid>https://orcid.org/0000-0003-0449-2375</orcidid><orcidid>https://orcid.org/0000-0001-7017-0150</orcidid><orcidid>https://orcid.org/0000-0002-2193-1512</orcidid></search><sort><creationdate>20211118</creationdate><title>Suppression of Electrographic Seizures Is Associated with Amelioration of QTc Interval Prolongation in Patients with Traumatic Brain Injury</title><author>Dabrowski, Wojciech ; Siwicka-Gieroba, Dorota ; Schlegel, Todd T. ; Robba, Chiara ; Zaid, Sami ; Bielacz, Magdalena ; Jaroszynski, Andrzej ; Badenes, Rafael</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-9ff214647e5329ae897fe6782e48d3682e9e5132083d44748846711578268ee73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Anesthesia</topic><topic>Clinical medicine</topic><topic>Convulsions & seizures</topic><topic>Electroencephalography</topic><topic>Fentanyl</topic><topic>General & Internal Medicine</topic><topic>Intensive care</topic><topic>Life Sciences & Biomedicine</topic><topic>Medicin och hälsovetenskap</topic><topic>Medicine, General & Internal</topic><topic>Metabolism</topic><topic>Potassium</topic><topic>Science & Technology</topic><topic>Traumatic brain injury</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dabrowski, Wojciech</creatorcontrib><creatorcontrib>Siwicka-Gieroba, Dorota</creatorcontrib><creatorcontrib>Schlegel, Todd T.</creatorcontrib><creatorcontrib>Robba, Chiara</creatorcontrib><creatorcontrib>Zaid, Sami</creatorcontrib><creatorcontrib>Bielacz, Magdalena</creatorcontrib><creatorcontrib>Jaroszynski, Andrzej</creatorcontrib><creatorcontrib>Badenes, Rafael</creatorcontrib><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Web of Science - Science Citation Index Expanded - 2021</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Proquest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Freely available online</collection><collection>SwePub Articles full text</collection><jtitle>JOURNAL OF CLINICAL MEDICINE</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dabrowski, Wojciech</au><au>Siwicka-Gieroba, Dorota</au><au>Schlegel, Todd T.</au><au>Robba, Chiara</au><au>Zaid, Sami</au><au>Bielacz, Magdalena</au><au>Jaroszynski, Andrzej</au><au>Badenes, Rafael</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Suppression of Electrographic Seizures Is Associated with Amelioration of QTc Interval Prolongation in Patients with Traumatic Brain Injury</atitle><jtitle>JOURNAL OF CLINICAL MEDICINE</jtitle><stitle>J CLIN MED</stitle><date>2021-11-18</date><risdate>2021</risdate><volume>10</volume><issue>22</issue><spage>5374</spage><pages>5374-</pages><artnum>5374</artnum><issn>2077-0383</issn><eissn>2077-0383</eissn><abstract><![CDATA[Introduction: Disorders in electroencephalography (EEG) are commonly noted in patients with traumatic brain injury (TBI) and may be associated with electrocardiographic disturbances. Electrographic seizures (ESz) are the most common features in these patients. This study aimed to explore the relationship between ESz and possible changes in QTc interval and spatial QRS-T angle both during ESz and after ESz resolution. Methods: Adult patients with TBI were studied. Surface 12-lead ECGs were recorded using a Cardiax device during ESz events and 15 min after their effective suppression using barbiturate infusion. The ESz events were diagnosed using Masimo Root or bispectral index (BIS) devices. Results: Of the 348 patients considered for possible inclusion, ESz were noted in 72, with ECG being recorded in 21. Prolonged QTc was noted during ESz but significantly ameliorated after ESz suppression (540.19 & PLUSMN; 60.68 ms vs. 478.67 & PLUSMN; 38.52 ms, p < 0.001). The spatial QRS-T angle was comparable during ESz and after treatment. Regional cerebral oximetry increased following ESz suppression (from 58.4% & PLUSMN; 6.2 to 60.5% & PLUSMN; 4.2 (p < 0.01) and from 58.2% & PLUSMN; 7.2 to 60.8% & PLUSMN; 4.8 (p < 0.05) in the left and right hemispheres, respectively). Conclusion: QTc interval prolongation occurs during ESz events in TBI patients but both it and regional cerebral oximetry are improved after suppression of seizures.]]></abstract><cop>BASEL</cop><pub>Mdpi</pub><pmid>34830656</pmid><doi>10.3390/jcm10225374</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-1001-0080</orcidid><orcidid>https://orcid.org/0000-0003-1997-3227</orcidid><orcidid>https://orcid.org/0000-0001-8194-1723</orcidid><orcidid>https://orcid.org/0000-0003-0449-2375</orcidid><orcidid>https://orcid.org/0000-0001-7017-0150</orcidid><orcidid>https://orcid.org/0000-0002-2193-1512</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Anesthesia Clinical medicine Convulsions & seizures Electroencephalography Fentanyl General & Internal Medicine Intensive care Life Sciences & Biomedicine Medicin och hälsovetenskap Medicine, General & Internal Metabolism Potassium Science & Technology Traumatic brain injury |
| title | Suppression of Electrographic Seizures Is Associated with Amelioration of QTc Interval Prolongation in Patients with Traumatic Brain Injury |
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