Analysis of factors influencing admission to intensive care following convulsive status epilepticus in children.
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Affiliation
Department of Neurosciences, Our Lady's Hospital for Children, Crumlin, Dublin, 12, Ireland.Issue Date
2012-02-01T10:24:08ZMeSH
Anticonvulsants/administration & dosageBenzodiazepines/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
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Seizure. 2009 Nov;18(9):630-3. Epub 2009 Aug 21.Journal
Seizure : the journal of the British Epilepsy AssociationDOI
10.1016/j.seizure.2009.07.006PubMed ID
19699662Abstract
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
engISSN
1532-2688 (Electronic)1059-1311 (Linking)
ae974a485f413a2113503eed53cd6c53
10.1016/j.seizure.2009.07.006
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