Electrographic Status Epilepticus Is Associated With Mortality and Worse Short-Term Outcome in Critically Ill Children*

Introduction. Refractory status epilepticus (RSE) has significant morbidity and mortality, and its management requires an accurate diagnosis and aggressive treatment. Objectives. To describe the experience of management of RSE in a neurological intensive care unit (NeuroICU) and determine predictors of short-term clinical outcome. Methods. We reviewed cases of RSE from September 2007 to December 2008. Management was titrated to findings on continuous video EEG (cVEEG). We collected patients’ demographics, RSE etiology, characteristics of seizures, cVEEG findings, treatments, and short-term outcome. Control of RSE was to achieve burst suppression pattern or electrographic cessation of ictal activity. Results. We included 80 patients; 63.8% were in coma, 25% had subclinical seizures, and 11.3% had focal activity. 51.3% were male and mean age was 45 years. Etiology was neurological lesion in 75.1%, uncontrolled epilepsy in 20%, and systemic derangements in 4.9%. 78.8% were treated with general anesthesia and concomitant anticonvulsant drugs. The control of RSE was 87.5% of patients. In-hospital mortality was 22.5%. The factors associated with unfavorable short-term outcome were coma and age over 60 years. Conclusions. RSE management guided by cVEEG is associated with a good seizure control. A multidisciplinary approach can help achieve a better short-term functional outcome in noncomatose patients.

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Rhythmical and Periodic EEG Patterns Do Not Predict Short-term Outcome in Critically Ill Patients With Subarachnoid Hemorrhage

Journal of Clinical Neurophysiology ◽

10.1097/wnp.0b013e3182933d2f ◽

2013 ◽

Vol 30 (3) ◽

pp. 247-254 ◽

Cited By ~ 23

Author(s):

Amy Z. Crepeau ◽

John F. Kerrigan ◽

Paula Gerber ◽

Gunjan Parikh ◽

Heidi Jahnke ◽

...

Keyword(s):

Subarachnoid Hemorrhage ◽

Critically Ill ◽

Critically Ill Patients ◽

Short Term ◽

Term Outcome ◽

Short Term Outcome

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Incidence, cause, and short-term outcome of convulsive status epilepticus in childhood: prospective population-based study

Yearbook of Pediatrics ◽

10.1016/s0084-3954(08)70464-0 ◽

2008 ◽

Vol 2008 ◽

pp. 352-355

Author(s):

J.A. Stockman

Keyword(s):

Status Epilepticus ◽

Population Based ◽

Convulsive Status Epilepticus ◽

Short Term ◽

Term Outcome ◽

Population Based Study ◽

Short Term Outcome

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Factors Affecting Short-Term Outcome of Critically Ill Children with Malignancies Admitted in Pediatric Intensive Care Unit: A Retrospective Observational Study

Indian Journal of Medical and Paediatric Oncology ◽

10.1055/s-0041-1733824 ◽

2021 ◽

Vol 42 (04) ◽

pp. 333-338

Author(s):

Priyanka Aggarwal ◽

Ishan Kumar ◽

Sunil Kumar Rao ◽

K Pradhap ◽

Vineeta Gupta

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Mechanical Ventilation ◽

Adverse Outcome ◽

Pediatric Intensive Care ◽

Critically Ill Children ◽

Short Term ◽

Term Outcome ◽

Short Term Outcome ◽

The Mean

Abstract Introduction Pediatric cancer contributes <1% of all malignancies. Childhood cancer survival has improved dramatically with the use of more intensive chemotherapy regimens, better stratification, and improvement in supportive care with enhanced facilities in pediatric intensive care unit (PICU). Objective The aim of this study was to identify the risk factors responsible for poor outcome in critically ill children with malignancies admitted in PICU. Materials and Methods Sixty-four children with a primary diagnosis of malignancy admitted in PICU with disease or treatment related complications were enrolled retrospectively. The short-term outcome, that is, shifting from PICU to ward, was assessed in relation to the presence of febrile neutropenia, organ failure, hepatitis, acute renal failure as well as requirement of inotropes and mechanical ventilation. Death was considered as an adverse outcome in this study. Results The mean age of study population was 6.25 ± 3.91 and M:F ratio 2.4:1. The majority of children had hematological malignancies (81.25%), that is, pre-B acute lymphoblastic leukemia (ALL) (45.3%), non-Hodgkin lymphoma (21.3%), acute myeloid leukemia (12.5%), T ALL (10.9%), and Hodgkin lymphoma (3.1%). Few children also had retinoblastoma (4.7%) and Langerhans cell histiocytosis (1.6%). The mean duration of PICU stay was 3.16 ± 2.31 days. Sepsis (37.5%) was the most common indication for PICU admission, followed by metabolic disturbance (26.6%), respiratory failure (17.2%), neurological complaints (15.6%), and anaphylactic shock (3.1%). Children requiring mechanical ventilation (p < 0.001), inotrope support (p < 0.001), having acute renal failure (p = 0.001), and >1 organ failure (p < 0.001) were associated with adverse outcome. The overall survival at the time of discharge from PICU was 64%. Conclusion In the context of low- and middle-income countries, optimal resource utilization by early identification of risk factors for clinical deterioration is required to allow timely admission to PICU and delivery of life-saving therapy to salvageable patients.

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