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Yavini Reddy, Yusentha Balakrishna, Lawrence Mubaiwa
PURPOSE: Convulsive status epilepticus (CSE) is associated with a high morbidity and mortality. This study aimed to describe the clinical profile, aetiology, neuroimaging and EEG findings as well as outcome of children with CSE in Sub-Saharan Africa. METHODS: This was a retrospective analysis of electronic records of children with CSE admitted to the Paediatric Intensive Care Unit (PICU) over an 8-year period from January 2007 to December 2014. RESULTS: Seventy six patients were admitted to the PICU with CSE and 55(72%) had refractory status epilepticus...
October 2017: Seizure: the Journal of the British Epilepsy Association
Olugbenga Akingbola, Dinesh Singh, Uwe Blecker
We present a case of recurrent bouts of irritability with arching, head extension, and lethargy in a previously healthy 10-month-old girl admitted to the PICU for acute onset of a movement disorder. The patient's vital signs and physical examination were unremarkable but recurrent bouts of abnormal movements persisted for the first 10 hours of admission in the PICU. Possible diagnoses, such as meningitis, status epilepticus, space occupying lesions, and toxic ingestions, were ruled out because of negative cerebrospinal fluid analysis, normal EEG, and negative results of other ancillary tests...
April 2017: Pediatrics
Yu Kawai, Andrea G DeMonbrun, Rebecca S Chambers, Danielle A Nolan, Bram A Dolcourt, Nasuh M Malas, Michael W Quasney
A 14-year-old previously healthy female was transferred from a local emergency department after being found unresponsive at home. Parental questioning revealed she had fever and pharyngitis 2 weeks before presentation. Past mental health history was negative, including concern for past or present suicidal ideation/attempts, suspected substance use, or toxic ingestion. In the emergency department, she was orotracheally intubated due to a Glasgow Coma Scale of 3. She was hemodynamically stable and euglycemic...
January 2017: Pediatrics
Y Cheng, Z J Lu, X G Yan, J He, G F Yan, X D Cai, W J Shen, A L Jin, G P Lu
Objective: To summarize the follow-up of children treated with venoarterial extracorporeal membrane oxygenation (ECMO) by incision of internal carotid artery-vein. Method: This was a retrospective study, 10 children in whom the conventional therapy failed, but survived after treatment with ECMO technique through right internal jugular artery-venous incision and ligation after ECMO in pediatric intensive care unit (PICU) of Fudan University were followed up from December 2011 to December 2015. Primary disease situation, neurological development, growth and development, quality of life and personality development were included...
November 2, 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Q Guan, S Li, X Li, H P Yang, Y Wang, X Y Liu
Objective: To evaluate the feasibility of using amplitude-integrated electroencephalogram (aEEG) to identify epileptic seizures by physicians and nurses in pediatric intensive care unit (PICU) independently. Method: Six testees (two PICU physicians versus one EEG physician and two PICU nurses versus one EEG technician) accepted a short-term training, then interpreted aEEG in a single blinded way. These aEEG recordings with synchronous VEEG monitoring were done from January 2013 to May 2015 in PICU. The testees should recognize and mark both the seizure type and the seizure duration from the two-channel recorder (C3/C4) of aEEG (short-term seizure or status epilepticus (SE))...
November 2, 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
F Chiusolo, A Diamanti, R Bianchi, L Fusco, M Elia, T Capriati, F Vigevano, S Picardo
BACKGROUND: Ketogenic diet (KD) has been used to treat refractory status epilepticus (RSE). KD is a high-fat, restricted-carbohydrate regimen that may be administered with different fat to protein and carbohydrate ratios (3:1 and 4:1 fat to protein and carbohydrate ratios). Other ketogenic regimens have a lower fat and higher protein and carbohydrate ratio to improve taste and thus compliance to treatment. We describe a case of RSE treated with intravenous KD in the Pediatric Intensive Care Unit (PICU)...
November 2016: European Journal of Paediatric Neurology: EJPN
Ramiz Coşkun Gündüz, Şanlıay Şahin, Mutlu Uysal-Yazıcı, Ganime Ayar, Halil İbrahim Yakut, Alkım Öden Akman, İbrahim Murat Hirfanoğlu, Gökhan Kalkan
We aimed to define the demographic characteristics, clinical features and outcome of patients with brain death, and to emphasize the importance of organ donation from children. Data for the period from September 2009 to October 2012 were collected retrospectively. Twenty children who were diagnosed as brain death were included. Data including demographics, major cause leading to brain death, duration of brain death evaluation, ancillary tests used to confirm brain death, complications and outcome, duration of hospitalization and organ donation were collected for statistical evaluation...
November 2014: Turkish Journal of Pediatrics
Sapna R Kudchadkar, Myron Yaster, Arjun N Punjabi, Stuart F Quan, James L Goodwin, R Blaine Easley, Naresh M Punjabi
STUDY OBJECTIVES: Although empirical evidence is limited, critical illness in children is associated with disruption of the normal sleep-wake rhythm. The objective of the current study was to examine the temporal characteristics of the sleep electroencephalogram (EEG) in a sample of children with critical illness. METHODS: Limited montage EEG recordings were collected for at least 24 hours from 8 critically ill children on mechanical ventilation for respiratory failure in a pediatric intensive care unit (PICU) of a tertiary-care hospital...
December 15, 2015: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Nicholas S Abend, Katherine L Wagenman, Taylor P Blake, Maria T Schultheis, Jerilynn Radcliffe, Robert A Berg, Alexis A Topjian, Dennis J Dlugos
PURPOSE: Electrographic seizures (ESs) and electrographic status epilepticus (ESE) are common in children with acute neurologic conditions in pediatric intensive care units (PICUs), and ESE is associated with worse functional and quality-of-life outcomes. As an exploratory study, we aimed to determine if ESE was associated with worse outcomes using more detailed neurobehavioral measures. METHODS: Three hundred children with an acute neurologic condition and altered mental status underwent clinically indicated EEG monitoring and were enrolled in a prospective observational study...
August 2015: Epilepsy & Behavior: E&B
Katherine L Wagenman, Taylor P Blake, Sarah M Sanchez, Maria T Schultheis, Jerilynn Radcliffe, Robert A Berg, Dennis J Dlugos, Alexis A Topjian, Nicholas S Abend
OBJECTIVE: Electrographic seizures (ES) and electrographic status epilepticus (ESE) are common in children in the pediatric intensive care unit (PICU) with acute neurologic conditions. We aimed to determine whether ES or ESE was associated with worse long-term outcomes. METHODS: Three hundred children with an acute neurologic condition and encephalopathy underwent clinically indicated EEG monitoring and were enrolled in a prospective observational study. We aimed to obtain follow-up data from 137 subjects who were neurodevelopmentally normal before PICU admission...
February 4, 2014: Neurology
Daniel H Arndt, Jason T Lerner, Joyce H Matsumoto, Andranik Madikians, Sue Yudovin, Hannah Valino, David L McArthur, Joyce Y Wu, Michelle Leung, Farzad Buxey, Conrad Szeliga, Michele Van Hirtum-Das, Raman Sankar, Amy Brooks-Kayal, Christopher C Giza
PURPOSE: Traumatic brain injury (TBI) is an important cause of morbidity and mortality in children, and early posttraumatic seizures (EPTS) are a contributing factor to ongoing acute damage. Continuous video-EEG monitoring (cEEG) was utilized to assess the burden of clinical and electrographic EPTS. METHODS: Eighty-seven consecutive, unselected (mild - severe), acute TBI patients requiring pediatric intensive care unit (PICU) admission at two academic centers were monitored prospectively with cEEG per established clinical TBI protocols...
October 2013: Epilepsia
John M Schreiber, Tesfaye Zelleke, William D Gaillard, Himanshu Kaulas, Nathan Dean, Jessica L Carpenter
OBJECTIVES: In this study, we aimed to determine the incidence of electrographic seizures among patients in a pediatric intensive care unit (PICU) presenting with acute encephalopathy. Risk factors and duration of continuous EEG monitoring needed to capture electrographic seizures were also assessed. STUDY DESIGN: Based on a NeuroICU clinical care pathway, all patients with acute encephalopathy admitted to the PICU are monitored with continuous video electroencephalogram (cVEEG) for 48 h or until the encephalopathy improves...
August 2012: Neurocritical Care
Carmelo Minardi, Emre Sahillioğlu, Marinella Astuto, Marco Colombo, Pablo Mauricio Ingelmo
Almost all children in the pediatric intensive care (PICU) need analgesia and/or sedation. Analgesics drugs are used to control pain from surgical incisions, drainages, vascular access or endotracheal suctioning. Sedatives are used to facilitate the delivery of nursing care, to facilitate mechanical ventilation, prevent self-extubation and to minimize patient discomfort. A therapeutic plan for analgesia and sedation should be established for each patient and regularly reviewed. The most often used sedation agents in PICU patients are Morphine or Fentanyl alone or in combination with Midazolam...
June 2012: Current Drug Targets
Ignacio Valencia, Germán Lozano, Sanjeev V Kothare, Joseph J Melvin, Divya S Khurana, H Huntley Hardison, Sabrina S Yum, Agustín Legido
PURPOSE: The clinical features of seizures occurring in the pediatric intensive care unit (PICU) setting are not well characterized. Adult ICU studies reveal an incidence of seizures ranging from 0.8% to 3.3%, with vascular, metabolic abnormalities, and drug withdrawal being the most common etiologies. The objective of this study is to investigate the clinical characteristics of seizures in children admitted to the PICU at our institution. METHODS: We performed a retrospective review of all patients with diagnoses of seizures or epilepsy, admitted to our PICU from 2002 to 2004...
December 2006: Epileptic Disorders: International Epilepsy Journal with Videotape
Montri Saengpattrachai, Rohit Sharma, Amrita Hunjan, Manohar Shroff, Ayako Ochi, Hiroshi Otsubo, Miguel A Cortez, O Carter Snead
PURPOSES: To determine the occurrence of nonconvulsive seizures (NCS) in the Pediatric Intensive Care Unit (PICU); to ascertain the relationship of NCS to past medical history, etiology, EEG, and brain imaging; and to determine the concordance between abnormal EEG findings and neuroimaging abnormalities. METHODS: A retrospective review was conducted of all pediatric patients who were admitted or transferred to the PICU from January 2000 to December 2003 with an unexplained decrease in level of consciousness, no overt clinical seizures, and EEG recordings performed within the 24 h of onset of an altered state of consciousness...
September 2006: Epilepsia
Gavin Morrison, Elizabeth Gibbons, William Patrick Whitehouse
OBJECTIVE: To assess the efficacy of high-dose midazolam in the treatment of refractory status epilepticus in children. SETTING: Paediatric intensive care unit (PICU). DESIGN: Audit of clinical experience. SUBJECTS: Seventeen consecutive patients treated for episodes of refractory status epilepticus. INTERVENTIONS: Algorithm-driven administration of intravenous midazolam to control RSE. Regular, mandatory, patient evaluation to avoid delay in the appropriate escalation of therapy...
December 2006: Intensive Care Medicine
Andreas E Triltsch, Grit Nestmann, Helmut Orawa, Maryam Moshirzadeh, Michael Sander, Joachim Grosse, Arka Genähr, Wolfgang Konertz, Claudia D Spies
INTRODUCTION: Most clinicians give sedatives and analgesics according to their professional experience and the patient's estimated need for sedation. However, this approach is prone to error. Inadequate monitoring of sedation and analgesia may contribute to adverse outcomes and complications. With this in mind, data obtained continuously using nonstimulating methods such as bispectral index (BIS) may have benefits in comparison with clinical monitoring of sedation. The aim of this prospective observational trial was to evaluate the use of electroencephalographic (EEG) BIS for monitoring sedation in paediatric intensive care unit (PICU) patients...
February 2005: Critical Care: the Official Journal of the Critical Care Forum
C Ross, A Blake, W P Whitehouse
A pilot study was undertaken of the feasibility of continuous EEG monitoring of patients admitted to a Paediatric Intensive Care Unit (PICU) for management of status epilepticus or its immediate sequelae. Eight children were studied and seizure activity was recorded in four patients. Additional information influencing management was obtained: the bedside nurse considered decerebrate posturing in one patient to be a seizure: there were no epileptiform EEG changes. Another patient was considered to have seizures (clonic movements of both upper limbs) following cardiac arrest; the EEG showed electrocerebral silence, and thiopentone treatment was discontinued...
September 1999: Seizure: the Journal of the British Epilepsy Association
Y Si, J Gotman, A Pasupathy, D Flanagan, B Rosenblatt, R Gottesman
OBJECTIVES: was to design a warning system for the pediatric intensive care unit (PICU). The system should be able to make statements at regular intervals about the level of abnormality of the EEG. The warnings are aimed at alerting an expert that the EEG may be abnormal and needs to be examined. METHODS: A total of 188 EEG sections lasting 6 h each were obtained from 74 patients in the PICU. Features were extracted from these EEGs, and with the use of fuzzy logic and neural networks, we designed an expert system capable of imitating a trained EEGer in providing an overall judgment of abnormality about the EEG...
June 1998: Electroencephalography and Clinical Neurophysiology
M A Frías Pérez, J L Pérez Navero, I Ibarra de la Rosa, M Lorente Acosta, M J Velasco Jabalquinto, E Ulloa Santamaría
OBJECTIVE: The purpose of this study was to analyze the etiology, evolution and predictive value of clinical variables and complementary explorations in children admitted to a PICU with hypoxic-ischemic coma. PATIENTS AND METHODS: A retrospective review (1991-1996) of 24 children with hypoxic-ischemic coma admitted to the pediatric ICU of a reference hospital was performed. Clinical data on admission and results of complementary explorations (EEG and neuroimaging techniques) were collected and the findings compared according to the evolution and underlying pathophysiological mechanism...
December 1997: Anales Españoles de Pediatría
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