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Author Notes:

Correspondence: Atul Vats, atul.vats@choa.org

JV collected and analyzed data and wrote and edited the manuscript.

MJ and QL performed data collection and analysis.

TA and PK supervised and mentored JV, MJ, and QL assisted with data analysis and edited and revised the manuscript.

JS was involved in study design, and manuscript revision.

LO initiated the study, collected the data, and supervised all aspects of the study and manuscript preparation.

AV is the primary mentor and coordinator for this study, provided oversight for all participants and reviewed and revised the manuscript.

VPS data was provided by Virtual Pediatric Systems, LLC (VPS). No endorsement or editorial restriction of the interpretation of these data or opinions of the authors has been implied or stated.

We are also grateful to Ashley Sweeney BA, RN for serving as the VPS Site Coordinator at Children's.

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Subjects:

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Pediatrics
  • continuous EEG
  • pediatric
  • non-convulsive
  • intensive care
  • brain injury
  • CRITICALLY-ILL CHILDREN
  • NONCONVULSIVE SEIZURES
  • CONSENSUS STATEMENT
  • COMATOSE CHILDREN
  • CONTINUOUS EEG
  • VIDEO-EEG
  • PREDICTORS

Risk Factors for Seizures Among Young Children Monitored With Continuous Electroencephalography in Intensive Care Unit: A Retrospective Study

Tools:

Journal Title:

Frontiers in Pediatrics

Volume:

Volume 6

Publisher:

, Pages 303-303

Type of Work:

Article | Final Publisher PDF

Abstract:

Objective: cEEG is an emerging technology for which there are no clear guidelines for patient selection or length of monitoring. The purpose of this study was to identify subgroups of pediatric patients with high incidence of seizures. Study Design: We conducted a retrospective study on 517 children monitored by cEEG in the intensive care unit (ICU) of a children's hospital. The children were stratified using an age threshold selection method. Using regression modeling, we analyzed significant risk factors for increased seizure risk in younger and older children. Using two alternative correction procedures, we also considered a relevant comparison group to mitigate selection bias and to provide a perspective for our findings. Results: We discovered an approximate risk threshold of 14 months: below this threshold, the seizure risk increases dramatically. The older children had an overall seizure rate of 18%, and previous seizures were the only significant risk factor. In contrast, the younger children had an overall seizure rate of 45%, and the seizures were significantly associated with hypoxic-ischemic encephalopathy (HIE; p = 0.007), intracranial hemorrhage (ICH; p = 0.005), and central nervous system (CNS) infection (p = 0.02). Children with HIE, ICH, or CNS infection accounted for 61% of all seizure patients diagnosed through cEEG under 14 months. Conclusions: An extremely high incidence of seizures prevails among critically ill children under 14 months, particularly those with HIE, ICH, or CNS infection.

Copyright information:

© 2018 Vlachy, Jo, Li, Ayer, Keskinocak, Swann, Olson and Vats.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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