Immediate postoperative course in the pediatric intensive care unit following epilepsy surgery.

Autor: Ayalon I; Pediatric Intensive Care Unit, affiliated to the Faculty of Medical and Health Sciences Tel Aviv University, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 6423906, Tel Aviv, Israel. itayay@tlvmc.gov.il., Friedman S; Pediatric Intensive Care Unit, affiliated to the Faculty of Medical and Health Sciences Tel Aviv University, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 6423906, Tel Aviv, Israel., Meidan B; Pediatric Intensive Care Unit, affiliated to the Faculty of Medical and Health Sciences Tel Aviv University, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 6423906, Tel Aviv, Israel., Sadot E; Pediatric Intensive Care Unit, affiliated to the Faculty of Medical and Health Sciences Tel Aviv University, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 6423906, Tel Aviv, Israel., Constantini S; Department of Pediatric Neurosurgery, The Pediatric Brain Center, affiliated to the Faculty of Medical and Health Sciences, Tel Aviv University, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel., Uliel-Sibony S; Pediatric Neurology Unit, The Pediatric Brain Center, affiliated to the Faculty of Medical and Health Sciences, Tel Aviv University, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel., Roth J; Department of Pediatric Neurosurgery, The Pediatric Brain Center, affiliated to the Faculty of Medical and Health Sciences, Tel Aviv University, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Jazyk: angličtina
Zdroj: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery [Childs Nerv Syst] 2024 Dec 06; Vol. 41 (1), pp. 36. Date of Electronic Publication: 2024 Dec 06.
DOI: 10.1007/s00381-024-06681-5
Abstrakt: Purpose: To describe the immediate postoperative PICU course and short-term outcomes of children undergoing various epilepsy surgeries.
Methods: Single-center, retrospective observational study. All patients younger than 20 years of age who had been admitted to the PICU between 2018 and 2022 following epilepsy surgery were eligible for study entry.
Results: Fifty-two children (median age 7.9 years) underwent epilepsy surgery during the study period (25 focal lesionectomies and lobectomies [FL], 10 corpus callosotomy [CC], and 17 hemispheric surgeries [HS]). The average number of preoperative antiseizure medications (ASM) was 3, and the average number of failed ASM was 6. Cortical dysplasia was the most frequent etiology (25%). Preoperative cognitive delay and motor deficits were reported in 38 (74%) and 26 (50%) patients, respectively. The median length of stay in the PICU was 1 day (5 for the HS group). No seizures occurred among 44 (85%) children during the first postoperative day nor during the entire hospital stay in 40 (77%) patients (20/25 [82%] in the FL group, 4/10 [40%] in the CC group, and 14/17 [82%] in the HS group). There were no status epilepticus events during the PICU stay. None of patients required hemodynamic support, and only 3(6%) needed respiratory support. Twenty-six patients (50%) had electrolyte abnormalities. Pain was mostly perceived as mild. Fever was present in 28 (54%) patients, most notably in the HS group (94%).
Conclusion: Epilepsy surgery in children is associated with very limited immediate postoperative morbidity and low seizure burden, especially in the FL and HS groups.
Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Patient consent: Due to the retrospective nature of this study, the institutional ethics committee of the participating site waived the requirement of obtaining informed consent. Ethics statement: This retrospective chart review study involving human participants was in accordance with the ethical standards of the institutional and with the 1964 Helsinki Declaration and its later amendments. It was approved by the ethics committee of the participating site (TLV- 0313–22 date of approval 03 Aug 2022).
(© 2024. The Author(s).)
Databáze: MEDLINE
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