Treatment of Seizures in Neonate With HIE

Comparison of findings anti-seizure Medication safety and efficacy

A complete 24-hour seizure-free period is measured and assessed by clinical symptoms and/or an independent aEEG assessment of seizure-free within 20 to 40 minutes of initiating drug therapy, without the need for second-line antiepileptic therapy.

Comparison of the effectiveness of anti-seizure medications for 48 continuous hours after the start of treatment.

1. Sustained seizure cessation (48 h): Absence of clinical or electrographic seizures for ≥48 consecutive hours after antiseizure therapy. Unit: Yes/No 2. Need for inotropes/vasopressors: Requirement for vasoactive agents (e.g., dopamine) for hypotension within 48 hours. Unit: Yes/No 3. Respiratory support requirement: Need for supplemental oxygen or ventilatory support (CPAP/NIV/mechanical ventilation). Unit: Yes/No 4. Feeding intolerance: Vomiting, abdominal distension, or interruption of enteral feeding. Unit: Yes/No 5. Hematologic abnormalities: Anemia (Hb \<13 g/dL), thrombocytopenia (platelets \<150×10⁹/L), or leukopenia (WBC \<5×10⁹/L). Unit: ×10³/µL 6. Electrolyte disturbances: Abnormal Na, K, Ca, or glucose levels per neonatal reference ranges. Unit: mmol/L 7. Acute liver injury: AST or ALT \>2× age-adjusted upper limit. Unit: IU/L 8. Hyperammonemia: Plasma ammonia \>100 µmol/L. Unit: µmol/L 9. Abnormal blood gas: Metabolic or respiratory acidosis: pH \<7.25 and/or BE ≤ -10 mmol/L.