학술논문

Analysis for hypercapnia associated with child seizure / 小児痙攣に伴う高CO2血症に関する検討
Document Type
Journal Article
Source
日本救急医学会雑誌 / Nihon Kyukyu Igakukai Zasshi. 2014, 25(4):135
Subject
capnomonitor
neurogenic pulmonary edema
pediatric emergency
status epilepticus
カプノモニター
小児救急
痙攣重積
神経原性肺水腫
Language
Japanese
ISSN
0915-924X
1883-3772
Abstract
Background: Seizure is the most common reason for transport to the hospital by ambulance. It is important to assess both the airway and respiratory status, to provide oxygen, and to assist ventilation as necessary. Object of this study is to analyze about risk factors for hypercapnia after seizure.Patients and Method: From January 2008 to December 2010, the records of venous blood gas taken from the patients under fifteen years old transported to hospital because of seizure were reviewed. Hypercapnia was defined as a partial pressure of carbon dioxide (PaCO2) over 65 mmHg, indicating respiratory failure.Results: Over the study period, 2105 patients were transported to our emergency room by ambulance of which 799 patients had seizures. Blood gas samples were collected in 627 patients, and only 21 patients were hypercapnic. A significant difference existed with difference in presence of vomiting and status epilepticus as evaluated by the multiple linear regression analysis.Discussion: Risk factors for hypercapnia are presence of vomiting and status epilepticus. It is possible that seizureassociated ventilatory failure is the direct reason for impaired consciousness during transport. Therefore, it is essential to provide oxygen and artificial ventilation.Conclusion: When a patient presenting seizure is being transported, it is important to concentrate on controlling seizure and respiration. The potential role of capnography during transport is an area that warrants future research.