Seizures in 204 comatose children: incidence and outcome
Intensive Care Medicine,

Kirkham FJ et al. – Seizures are common in comatose children, and are associated with an unfavourable outcome in survivors. Continuous electroencephalographic monitoring (cEEG) allows the detection of subtle clinical seizures (CS) and non–convulsive seizures, NCS) and is a prognostic tool.

Methods
  • cEEG (one to three channels) was performed for a median 42h (range 2–630h) in 204 unventilated and ventilated children aged ≤15years (18 neonates, 61 infants) in coma with different aetiologies.
  • Outcome at 1month was independently determined and dichotomized for survivors into favourable (normal or moderate neurological handicap) and unfavourable (severe handicap or vegetative state).

Results
  • Of the 204 patients, 110 had clinical seizures (CS) before cEEG commenced.
  • During cEEG, 74 patients (36 %, 95 % confidence interval, 95 % CI, 32–41 %) had electroencephalographic seizures (ES), the majority without clinical accompaniment (non–convulsive seizures, NCS).
  • CS occurred before NCS in 69 of the 204 patients; 5 ventilated with NCS had no CS observed.
  • Death (93/204; 46 %) was independently predicted by admission Paediatric Index of Mortality (PIM; adjusted odds ratio, aOR, 1.027, 95 % CI 1.012–1.042; p<0.0005), Adelaide coma score (aOR 0.813, 95 % CI 0.700–0.943; p=0.006), and EEG grade on admission (excess slow with >3 % fast, aOR 5.43, 95 % CI 1.90–15.6; excess slow with <3 % fast, aOR 8.71, 95 % CI 2.58–29.4; low amplitude, 10th centile <9µV, aOR 3.78, 95 % CI 1.23–11.7; and burst suppression, aOR 10.68, 95 % CI 2.31–49.4) compared with normal cEEG, as well as absence of CS at any time (aOR 2.38, 95 % CI 1.18–4.81).
  • Unfavourable outcome (29/111 survivors; 26 %) was independently predicted by the presence of ES (aOR 15.4, 95 % CI 4.7–49.7) and PIM (aOR 1.036, 95 % CI 1.013–1.059).

Please login or register to follow this author.
Are you sure you want to Unfollow this Author?
► Click here to access PubMed, Publisher and related articles...

Your Unread Messages in Nurse Practitioner

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Nurse Practitioner Articles

1 Long-term associations of nut consumption with body weight and obesity American Journal of Clinical Nutrition, June 23, 2014    Clinical Article

2 Nuts in the prevention and treatment of metabolic syndrome American Journal of Clinical Nutrition, June 5, 2014    Review Article

3 Nut consumption and risk of type 2 diabetes, cardiovascular disease, and all-cause mortality: a systematic review and meta-analysis American Journal of Clinical Nutrition, June 4, 2014    Evidence Based Medicine    Review Article

4 Fish consumption, sleep, daily functioning, and heart rate variability Journal of Clinical Sleep Medicine, June 12, 2014    Clinical Article

5 Yogurt and weight management American Journal of Clinical Nutrition, April 3, 2014    Review Article

6 Dietary patterns and breast cancer risk among women Public Health Nutrition, April 4, 2014    Clinical Article

7 Consumption of nuts and legumes and risk of incident ischemic heart disease, stroke, and diabetes: a systematic review and meta-analysis American Journal of Clinical Nutrition, June 19, 2014    Evidence Based Medicine    Review Article

8 Randomized clinical trial of hydrocodone/acetaminophen versus codeine/acetaminophen in the treatment of acute extremity pain after emergency department discharge Academic Emergency Medicine, March 21, 2014    Clinical Article

9 A review of the effects of nuts on appetite, food intake, metabolism, and body weight American Journal of Clinical Nutrition, June 26, 2014    Review Article

10 Effect of two dietary fibers on satiety and glycemic parameters: A randomized, double-blind, placebo-controlled, exploratory study Full Text Nutrition Journal, June 2, 2014    Free full text    Clinical Article

11 Effects of omega 3 supplementation in elderly patients with acute myocardial infarction: design of a prospective randomized placebo controlled study Full Text BMC Geriatrics, June 27, 2014    Free full text    Clinical Article

12 High-fiber orange juice as a nutrition supplement in women: a randomized, double-blind, placebo-controlled study of tolerance and effectiveness Journal of Parenteral and Enteral Nutrition, June 25, 2014    Clinical Article

13 Quantitative analysis of dietary protein intake and stroke risk Neurology┬«, June 16, 2014    Review Article    Clinical Article

14 Meta-analysis of prospective studies on the effects of nut consumption on hypertension and type 2 diabetes mellitus Journal of Diabetes, June 10, 2014    Evidence Based Medicine

15 Cannabis smoking and lung cancer risk: Pooled analysis in the International Lung Cancer Consortium International Journal of Cancer, June 23, 2014    Clinical Article

16 Dance therapy in patients with chronic heart failure: A systematic review and a meta-analysis Clinical Rehabilitation, June 3, 2014    Evidence Based Medicine    Review Article

17 Vitamin D levels in a paediatric population of normal weight and obese subjects Full Text Journal of Endocrinological Investigation, June 18, 2014    Free full text    Clinical Article

18 Vegetarian diets and bone status American Journal of Clinical Nutrition, June 19, 2014    Clinical Article

19 Mediterranean dietary pattern, inflammation and endothelial function: A systematic review and meta-analysis of intervention trials Nutrition, Metabolism & Cardiovascular Diseases, May 9, 2014    Evidence Based Medicine    Review Article

20 Vitamin D and mortality: meta-analysis of individual participant data from a large consortium of cohort studies from Europe and the United States BMJ, June 24, 2014    Evidence Based Medicine    Clinical Article

Indexed Journals in Nurse Practitioner: Journal of the American Academy of Nurse Practitioners, Holistic Nursing Practicemore

Register now to view all the MDLinx contents (FREE)!

  • Stay current on the latest literature, research and clinical news
  • Get special communications and offers from MDLinx and our sponsors
  • Receive invitations to paid market research
View Samples and Register

Connect with us, stay current.

Receive the latest mecial news
updates for free via email

Sign up!

Subscribe to our free RSS feeds:

Get the latest news in your specialty automatically added to your newsreader or your personal My Yahoo!, Google, My MSN or My AOL page. Learn More

Close