{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T05:54:18Z","timestamp":1781589258126,"version":"3.54.5"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Readily accessible biomarkers for early seizure recurrence in benign convulsions with mild gastroenteritis (CwG) are lacking. We evaluated whether admission serum total carbon dioxide (TCO\n                      <jats:sub>2<\/jats:sub>\n                      ), a routine venous surrogate for bicarbonate, predicts seizure recurrence within 48\u2005h in children with CwG.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective study included children aged 6 months to 6 years diagnosed with CwG (2020\u20132026). Multivariable logistic regression evaluated the association between admission venous TCO\n                      <jats:sub>2<\/jats:sub>\n                      and seizure recurrence within 48\u2005h, adjusting for age and anticonvulsant use. Model performance underwent bootstrap internal validation. TCO\n                      <jats:sub>2<\/jats:sub>\n                      \/bicarbonate concordance was assessed in a paired subset.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 86 children (median age 14.5 months), 23 (26.7%) experienced recurrence. Median TCO\n                      <jats:sub>2<\/jats:sub>\n                      was higher in the recurrence group (17.4 vs. 15.1\u2005mmol\/L,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.007). In multivariable analysis, higher TCO\n                      <jats:sub>2<\/jats:sub>\n                      (odds ratio 1.235, 95% confidence interval 1.053\u20131.448;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.009) and younger age (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.016) were independently associated with recurrence. The optimism-corrected area under the curve was 0.710, calibration slope was 0.748, and Brier score was 0.164. A TCO\n                      <jats:sub>2<\/jats:sub>\n                      cutoff of 16.25\u2005mmol\/L yielded 78.3% sensitivity, 61.9% specificity, and 88.7% negative predictive value. In 29 paired samples, venous TCO\n                      <jats:sub>2<\/jats:sub>\n                      and arterial bicarbonate were strongly correlated (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.966,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Higher admission serum TCO\n                      <jats:sub>2<\/jats:sub>\n                      was independently associated with early seizure recurrence in CwG. As a readily accessible venous biomarker, TCO\n                      <jats:sub>2<\/jats:sub>\n                      may represent a candidate marker for bedside risk stratification to guide observation. These findings are hypothesis-generating, and external validation in prospective cohorts is warranted.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1884706","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T05:39:45Z","timestamp":1781588385000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Higher admission serum total carbon dioxide is independently associated with early seizure recurrence in children with benign convulsions with mild gastroenteritis"],"prefix":"10.3389","volume":"14","author":[{"given":"Ling","family":"Zou","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Zigong First People\u2019s Hospital","place":["Zigong, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Zigong First People\u2019s Hospital","place":["Zigong, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyu","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Zigong First People\u2019s Hospital","place":["Zigong, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihong","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Zigong First People\u2019s Hospital","place":["Zigong, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"key":"B1","first-page":"131","article-title":"Convulsions and mild diarrhea","volume":"23","author":"Morooka","year":"1982","journal-title":"Shonika (Tokyo"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e59","DOI":"10.1002\/pdi3.59","article-title":"Benign convulsions with mild gastroenteritis in children: an emerging acute 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