Electrographic Seizures and Brain Injury in Children Requiring Extracorporeal Membrane Oxygenation
| Autor: | Stephanie M. Rau, Faye S. Silverstein, Robin J. Cook, Yuki Peterson, Shannon G. Lester-Pelham, Julie Sturza, Renée A. Shellhaas, Timothy Vesper, Therese Adamowski |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
medicine.medical_specialty Neurology Adolescent medicine.medical_treatment Population Electroencephalography Tertiary Care Centers 03 medical and health sciences Young Adult 0302 clinical medicine Extracorporeal Membrane Oxygenation Developmental Neuroscience Risk Factors Seizures 030225 pediatrics Extracorporeal membrane oxygenation Medicine Humans Ictal education Child Retrospective Studies education.field_of_study medicine.diagnostic_test business.industry Infant Newborn Neurointensive care Infant Video electroencephalography Oxygenation Hospitals Pediatric Neurophysiological Monitoring Anesthesia Child Preschool Pediatrics Perinatology and Child Health Neurology (clinical) business Intracranial Hemorrhages 030217 neurology & neurosurgery |
| Zdroj: | Pediatric neurology. 108 |
| ISSN: | 1873-5150 |
| Popis: | Single-center studies suggest that up to 30% of children undergoing extracorporeal membrane oxygenation have electrographic seizures. The aim of this study was to characterize seizure prevalence, seizure risk factors, and brain injury prevalence in the pediatric extracorporeal membrane oxygenation population at a tertiary care children's hospital.We performed a retrospective systematic review of medical records for 86 consecutive children (neonates to age 21 years) who received Neurology consults and continuous video electroencephalography while undergoing extracorporeal membrane oxygenation from November 2015 to September 2018.Continuous video electroencephalography was initiated in 86 of 170 children who required extracorporeal membrane oxygenation (51%); median duration of continuous vodeo electroencephalography was four days. Nineteen of 86 had electroencephalography-confirmed seizures (22%). Sixteen of 19 had seizures within the first 48 hours on continuous video electroencephalography. Interictal epileptiform discharges were a significant risk factor for seizures; 89% of those with seizures versus 46% of those without had interictal epileptiform discharges (P 0.001, Fisher's exact test). Children with seizures also had higher pericannulation lactate (median 6.7, interquartile range of 4.3 to 19.0 for those with, and median 4.0, interquartile range of 2.0 to 7.3 for those without; P = 0.02, Mann-Whitney U test). Seizures were associated with hemorrhage on neuroimaging (68% of children with seizures had intracranial hemorrhage versus 34% of those without, P = 0.01, chi-square test).Approximately half the children undergoing extracorporeal membrane oxygenation received continuous video electroencephalography during the study period, and 22% had seizures. Interictal epileptiform discharges and elevated pre-extracorporeal membrane oxygenation lactate levels were risk factors for seizures; seizures were associated with intracranial hemorrhage. |
| Databáze: | OpenAIRE |
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