Evaluation of Patients with Status Epilepticus in The Pediatric Intensive Care Unit; Our Single-center Experience

Abstract

Objectives: Status epilepticus (SE) is one of the most common neurologic emergencies in children. The aim of this study was to investigate the clinical and demographic characteristics, treatment protocols, and outcomes of patients in our pediatric intensive care unit (PICU). Materials and Methods: Patients aged 1 month to 18 years, who were treated in the PICU with a diagnosis of SE between January 2020 and September 2021, were retrospectively evaluated. Demographics, indications for hospitalization, etiology, and types of SE, treatment modalities, mortality, and morbidity were recorded. Results: Seventy two patients [29 (40.3%) female, 43 (59.7%) male] were enrolled in the study. The mean age of the patients was 11.78±12.87 months. Thirty-three (45.8%) patients were followed up with SE, 32 (44.4%) patients with refractory SE (RSE), and 7 (9.7%) patients with super RSE (SRSE). Most of the patients were in the age group of 1-5 years, and the most common etiology was remote symptomatic SE. Midazolam infusion was given to 40 (55.56%) patients, ketamine infusion to eight (11.11%) patients, thiopental infusion to seven (9.7%) patients, ketamine and propofol infusion to four (5%) patients, and valproic acid infusion to two (2.7%) patients. Seven patients (9.7%) died during the study, and the cause of death was due to their underlying diseases, independent of SE. Conclusion: Timely recognition of SE and timely administration of appropriate medications are important in the follow-up of critically ill children. Chronic underlying diseases of patients followed up with RSE and SRSE affect prognosis and mortality.

Keywords

• Status Epilepticus
• Pediatric Intensive Care
• Antiepileptic Drugs

Çocuk Yoğun Bakımda İzlenen Status Epileptikuslu Hastaların Değerlendirilmesi; Tek Merkez Deneyimimiz

Abstract

Amaç: Status epileptikus (SE) çocukluk çağının en sık görülen nörolojik acillerindendir. Bu çalışmada çocuk yoğun bakım ünitemizde (ÇYBÜ) SE tanısıyla takip edilen hastaların klinik ve demografik özelliklerinin incelenmesi, tedavi protokolleri ve sonuçların değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Üçüncü basamak olarak hizmet veren ÇYBÜ’de Ocak 2020-Eylül 2021 tarihleri arasında SE nedeni ile takip edilen 1 ay-18 yaş arası hastalar retrospektif olarak incelendi. Hastaların demografik verileri, yatış endikasyonları, SE etiyoloji ve tipleri, uygulanan tedavi, mortalite ve morbidite durumları kaydedildi. Bulgular: Çalışmaya 72 hasta [29 (%40,3) kız, 43 (%59,7) erkek] alındı. Hastaların yaş ortalaması 11,78±12,87 ay idi. Otuz üç (%45,8) hasta SE, 32 (%44,4) hasta refrakter SE (RSE), 7 (%9,7) hasta ise süper RSE (SRSE) ile takip edildi. En fazla hasta sayısı 1-5 yaş grubunda idi ve en sık SE etiyolojisi kronik statik santral sinir sistemi bozukluğu zemininde gelişen SE idi. Çalışmada 40 (%55,56) hastaya midazolam infüzyonu, sekiz (%11,11) hastaya ketamin infüzyonu, yedi (%9,7) hastaya tiopental infüzyonu, dört (%5) hastaya ketamin ve propofol infüzyonu, iki (%2,7) hastaya da valproik asid infüzyonu verildi. Tüm hastaların konvulziyonu kontrol altına alındı. Çalışmada yedi hasta (%9,7) kaybedildi. Bu hastaların ölüm sebebi SE’den bağımsız olarak altta yatan hastalıklarıydı. Sonuç: SE’nin zamanında tanınması ve uygun medikasyonun zamanında yapılması kritik hasta çocuk takibinde önemlidir. RSE ve SRSE ile takip edilen hastaların altta yatan süreğen hastalıkları, prognoz ve mortaliteye etki etmektedir.

Keywords

• Status Epileptikus
• Çocuk Yoğun Bakım
• Antiepileptik İlaç

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