title: 5% Carbon Dioxide is safe but of limited efficacy as a treatment for paediatric non-convulsive status epilepticus: An open label observational study.
abstract: OBJECTIVE
  To establish the efficacy and tolerability of inhaled 5% carbon dioxide/95% oxygen as a treatment for paediatric non-convulsive status epilepticus (NCSE).
  
  
  METHODS
  In an open label clinical trial, children in NCSE were given high flow inhaled 5% carbon dioxide/95% oxygen by face mask for 120 s under EEG control.
  
  
  RESULTS
  Six children (five male; ages 3-13; all with severe underlying epilepsy and disability) were recruited. Inhalation was well tolerated in all cases. Capillary blood gasses showed no significant derangements at the end of the inhalation. Effects on EEG normalisation were limited and transient, and no clinical improvements were noted. No adverse effects occurred.
  
  
  CONCLUSIONS
  Inhaled 5% carbon dioxide/95% oxygen has been suggested as a potent, well tolerated anticonvulsant. An anticonvulsant without sedating and respiration-depressing effects would be particularly welcome in the management of NCSE where the justification for aggressive anticonvulsant therapy is often uncertain, however it appears that 5% carbon dioxide is of limited efficacy in this context.
authors.affiliation: Institute of Neuroscience, Newcastle University, Newcastle upon Tyne NE1 7RU, UK; Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle NE1 4LP, UK. Electronic address: rob.forsyth@newcastle.ac.uk.
authors.forename: Rob
authors.initials: R
authors.lastname: Forsyth
authors.affiliation: Department of Paediatric Neurology, Royal Manchester Children's Hospital, Oxford Road, Manchester M13 9WL, UK.
authors.forename: Tim
authors.initials: T
authors.lastname: Martland
authors.affiliation: Department of Neurophysiology, Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle NE1 4LP, UK.
authors.forename: Ming
authors.initials: M
authors.lastname: Lai
authors.affiliation: Department of Paediatric Neurology, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK.
authors.forename: Gayatri
authors.initials: G
authors.lastname: Vadlamani
authors.affiliation: Newcastle Clinical Trials Unit, Institute of Health and Society, Newcastle University, Newcastle upon Tyne NE1 7RU, UK.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Hogan
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use; D001784:Blood Gas Analysis; D002245:Carbon Dioxide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography / Q000187:drug effects; D005260:Female; D006801:Humans; D008297:Male; D013226:Status Epilepticus / Q000188:drug therapy*
chemical_list: D000927:Anticonvulsants; D002245:Carbon Dioxide
keywords: Blood pH; Carbogen; Carbon dioxide; Children; Non-convulsive status epilepticus