Analysis of factors influencing admission to intensive care following convulsive status epilepticus in children.

Hdl Handle:
http://hdl.handle.net/10147/207404
Title:
Analysis of factors influencing admission to intensive care following convulsive status epilepticus in children.
Authors:
Tirupathi, Sandya; McMenamin, Joseph B; Webb, David W
Affiliation:
Department of Neurosciences, Our Lady's Hospital for Children, Crumlin, Dublin, 12, Ireland.
Citation:
Seizure. 2009 Nov;18(9):630-3. Epub 2009 Aug 21.
Journal:
Seizure : the journal of the British Epilepsy Association
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207404
DOI:
10.1016/j.seizure.2009.07.006
PubMed ID:
19699662
Abstract:
OBJECTIVES: To identify clinical features and therapeutic decisions that influence admission to the Intensive Care unit (ICU) in children presenting with convulsive status epilepticus (CSE). METHODS: We evaluated 47 admissions with status epilepticus to a tertiary paediatric hospital A&E over a three year period (2003-2006). Following initial management 23 episodes required admission to ICU and 24 were managed on a paediatric ward. We compared clinical, demographic data and compliance with our CSE protocol between the ICU and ward groups. RESULTS: Median age at presentation in the ICU group was 17 months (range 3 months-11 years) compared to 46 months in the ward group (range 3 months-10 years). Fifty per cent of patients in both groups had a previous history of seizures. Median duration of pre-hospital seizure activity was 30 min in both groups. More than two doses of benzodiazepines were given as first line medication in 62% of the ICU group and 33% of the ward group. Among children admitted to ICU with CSE, 26% had been managed according to the CSE protocol, compared to 66% of children who were admitted to a hospital ward. Febrile seizures were the most common aetiology in both groups. CONCLUSION: Younger age at presentation, administration of more than two doses of benzodiazepines and deviation from the CSE protocol appear to be factors which influence admission of children to ICU. Recognition of pre-hospital administration of benzodiazepines and adherence to therapeutic guidelines may reduce the need for ventilatory support in this group.
Language:
eng
MeSH:
Anticonvulsants/administration & dosage; Benzodiazepines/administration & dosage; Child; Child, Preschool; Dose-Response Relationship, Drug; Female; *Guideline Adherence; Humans; Infant; Intensive Care Units/*standards; Male; Patient Admission/*standards; Practice Guidelines as Topic; Status Epilepticus/*drug therapy
ISSN:
1532-2688 (Electronic); 1059-1311 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorTirupathi, Sandyaen_GB
dc.contributor.authorMcMenamin, Joseph Ben_GB
dc.contributor.authorWebb, David Wen_GB
dc.date.accessioned2012-02-01T10:24:08Z-
dc.date.available2012-02-01T10:24:08Z-
dc.date.issued2012-02-01T10:24:08Z-
dc.identifier.citationSeizure. 2009 Nov;18(9):630-3. Epub 2009 Aug 21.en_GB
dc.identifier.issn1532-2688 (Electronic)en_GB
dc.identifier.issn1059-1311 (Linking)en_GB
dc.identifier.pmid19699662en_GB
dc.identifier.doi10.1016/j.seizure.2009.07.006en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207404-
dc.description.abstractOBJECTIVES: To identify clinical features and therapeutic decisions that influence admission to the Intensive Care unit (ICU) in children presenting with convulsive status epilepticus (CSE). METHODS: We evaluated 47 admissions with status epilepticus to a tertiary paediatric hospital A&E over a three year period (2003-2006). Following initial management 23 episodes required admission to ICU and 24 were managed on a paediatric ward. We compared clinical, demographic data and compliance with our CSE protocol between the ICU and ward groups. RESULTS: Median age at presentation in the ICU group was 17 months (range 3 months-11 years) compared to 46 months in the ward group (range 3 months-10 years). Fifty per cent of patients in both groups had a previous history of seizures. Median duration of pre-hospital seizure activity was 30 min in both groups. More than two doses of benzodiazepines were given as first line medication in 62% of the ICU group and 33% of the ward group. Among children admitted to ICU with CSE, 26% had been managed according to the CSE protocol, compared to 66% of children who were admitted to a hospital ward. Febrile seizures were the most common aetiology in both groups. CONCLUSION: Younger age at presentation, administration of more than two doses of benzodiazepines and deviation from the CSE protocol appear to be factors which influence admission of children to ICU. Recognition of pre-hospital administration of benzodiazepines and adherence to therapeutic guidelines may reduce the need for ventilatory support in this group.en_GB
dc.language.isoengen_GB
dc.subject.meshAnticonvulsants/administration & dosageen_GB
dc.subject.meshBenzodiazepines/administration & dosageen_GB
dc.subject.meshChilden_GB
dc.subject.meshChild, Preschoolen_GB
dc.subject.meshDose-Response Relationship, Drugen_GB
dc.subject.meshFemaleen_GB
dc.subject.mesh*Guideline Adherenceen_GB
dc.subject.meshHumansen_GB
dc.subject.meshInfanten_GB
dc.subject.meshIntensive Care Units/*standardsen_GB
dc.subject.meshMaleen_GB
dc.subject.meshPatient Admission/*standardsen_GB
dc.subject.meshPractice Guidelines as Topicen_GB
dc.subject.meshStatus Epilepticus/*drug therapyen_GB
dc.titleAnalysis of factors influencing admission to intensive care following convulsive status epilepticus in children.en_GB
dc.contributor.departmentDepartment of Neurosciences, Our Lady's Hospital for Children, Crumlin, Dublin, 12, Ireland.en_GB
dc.identifier.journalSeizure : the journal of the British Epilepsy Associationen_GB
dc.description.provinceLeinster-
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