Late-Onset Findings During Extended EEG Monitoring Are Rare in Critically Ill Children.

Autor:	Fung FW; Department of Pediatrics (Division of Neurology), Children's Hospital of Philadelphia, Philadelphia, PA.; Departments of Neurology and Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA., Parikh DS; Department of Pediatrics (Division of Neurology), Children's Hospital of Philadelphia, Philadelphia, PA., Walsh K; Department of Pediatrics (Division of Neurology), Children's Hospital of Philadelphia, Philadelphia, PA., Fitzgerald MP; Department of Pediatrics (Division of Neurology), Children's Hospital of Philadelphia, Philadelphia, PA.; Departments of Neurology and Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA., Massey SL; Department of Pediatrics (Division of Neurology), Children's Hospital of Philadelphia, Philadelphia, PA.; Departments of Neurology and Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA., Topjian AA; Department of Anesthesia and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA; and.; Department of Anesthesia & Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA., Abend NS; Department of Pediatrics (Division of Neurology), Children's Hospital of Philadelphia, Philadelphia, PA.; Departments of Neurology and Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.; Department of Anesthesia & Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
Jazyk:	angličtina
Zdroj:	Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society [J Clin Neurophysiol] 2024 Apr 26. Date of Electronic Publication: 2024 Apr 26.
DOI:	10.1097/WNP.0000000000001083
Abstrakt:	Purpose: Electrographic seizures (ES) are common in critically ill children undergoing continuous EEG (CEEG) monitoring, and previous studies have aimed to target limited CEEG resources to children at highest risk of ES. However, previous studies have relied on observational data in which the duration of CEEG was clinically determined. Thus, the incidence of late occurring ES is unknown. The authors aimed to assess the incidence of ES for 24 hours after discontinuation of clinically indicated CEEG. Methods: This was a single-center prospective study of nonconsecutive children with acute encephalopathy in the pediatric intensive care unit who underwent 24 hours of extended research EEG after the end of clinical CEEG. The authors assessed whether there were new findings that affected clinical management during the extended research EEG, including new-onset ES. Results: Sixty-three subjects underwent extended research EEG. The median duration of the extended research EEG was 24.3 hours (interquartile range 24.0-25.3). Three subjects (5%) had an EEG change during the extended research EEG that resulted in a change in clinical management, including an increase in ES frequency, differential diagnosis of an event, and new interictal epileptiform discharges. No subjects had new-onset ES during the extended research EEG. Conclusions: No subjects experienced new-onset ES during the 24-hour extended research EEG period. This finding supports observational data that patients with late-onset ES are rare and suggests that ES prediction models derived from observational data are likely not substantially underrepresenting the incidence of late-onset ES after discontinuation of clinically indicated CEEG. (Copyright © 2024 by the American Clinical Neurophysiology Society.)
Databáze:	MEDLINE
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