Trial reportEuropean journal of pediatrics2006
Development of an optimal lidocaine infusion strategy for neonatal seizures.
Trial report in European journal of pediatrics, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 3 syntheses or guidelines pooled it, 80 citations in OpenAlex.
- Efficacy of the anti-seizure medications in acute symptomatic neonatal seizures caused by stroke. A systematic review.Acta bio-medica : Atenei Parmensis · 2022Pooled it
- Treating the symptom or treating the disease in neonatal seizures: a systematic review of the literature.Italian journal of pediatrics · 2021Pooled it
- Pharmacological treatment of neonatal seizures: a systematic review.Journal of child neurology · 2013Pooled it
- Novel Therapeutics for Neonatal Seizures.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2021Review
- Lidocaine as treatment for neonatal seizures: Evaluation of previously developed population pharmacokinetic models and dosing regimen.British journal of clinical pharmacology · 2020Article
- Status Epilepticus in the Neonate: Updates in Treatment Strategies.Current treatment options in neurology · 2019Review
- Pharmacotherapy for Seizures in Neonates with Hypoxic Ischemic Encephalopathy.Paediatric drugs · 2017Review
- Review
- Treating disorders of the neonatal central nervous system: pharmacokinetic and pharmacodynamic considerations with a focus on antiepileptics.British journal of clinical pharmacology · 2016Review
- Advances in management of neonatal seizures.Indian journal of pediatrics · 2014Review
- Neonatal seizures: advances in mechanisms and management.Clinics in perinatology · 2014Review
- Effects of xenon and hypothermia on cerebrovascular pressure reactivity in newborn global hypoxic-ischemic pig model.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2013Article
- Clinical management of seizures in newborns : diagnosis and treatment.Paediatric drugs · 2013Review
- Neonatal seizures: controversies and challenges in translating new therapies from the lab to the isolette.The European journal of neuroscience · 2012Review
- Pharmacokinetics and pharmacodynamics of medication in asphyxiated newborns during controlled hypothermia. The PharmaCool multicenter study.BMC pediatrics · 2012Article
- A systematic review of the pharmacokinetics of antiepileptic drugs in neonates with refractory seizures.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2012Article
- Neurocritical care for neonates.Current treatment options in neurology · 2011Article
- Lidocaine (lignocaine) dosing regimen based upon a population pharmacokinetic model for preterm and term neonates with seizures.Clinical pharmacokinetics · 2011Article
- Low dose lidocaine for refractory seizures in preterm neonates.Indian journal of pediatrics · 2011Article
- Neonatal seizures: an update on mechanisms and management.Clinics in perinatology · 2009Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionLidocaine is an effective drug for the treatment of neonatal convulsions not responding to traditional anticonvulsant therapy. However, one of the side-effects is a risk of cardiac arrhythmias. The aim of this study was to develop an optimal dosing strategy with minimal risk of cardiac arrhythmias. MATERIALS AND
methodsAs a first step, we studied 20 neonates during routine treatment of neonatal seizures with lidocaine. All were given a loading dose of 2 mg/kg in 10 min, followed by the continuous infusion of 6 mg/kg per hour for 12 h, 4 mg/kg per hour for 12 h and finally 2 mg/kg per hour for 12 h. Effectiveness, cardiac toxicity and lidocaine plasma concentrations were then determined.
resultsNo cardiac arrhythmias were observed, and lidocaine was effective in 76% of the treatments. In most of the treatments (13 out of 20) maximal lidocaine plasma concentrations were >9 mg/L. Plasma levels >9 mg/L have been related to cardiac toxicity when used as an anti-arrhythmic drug in adults. It was of interest that all preterm infants showed high lidocaine plasma levels. Secondly, we developed the optimal dosing regimen, which was defined as an infusion regimen at which maximal lidocaine plasma concentrations are <9 mg/L. Simulations with the developed pharmacokinetic model indicated a reduction in the infusion duration of lidocaine at 6 mg/kg per hour from 12 to 6 h. Thirdly, the new lidocaine dosing regimen was evaluated. Fifteen neonates (16 treatments) were studied. No cardiac arrhythmias were observed, and lidocaine was effective in 78% of the treatments. In most of the treatments (11 out of 16) maximal lidocaine plasma concentrations were <9 mg/L. Again preterm infants showed relatively high lidocaine plasma levels.
conclusionA new lidocaine dosing schedule was developed. This new regimen should have a lower risk of cardiac arrhythmias and appears to be as effective in term infants. For preterm infants the optimal regimen needs to be determined.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.