814 Outcome of Children Admitted to a Regional Paediatric Intensive Care Unit (PICU) with Convulsive Status Epilepticus (CSE)

Abstract

Background and Aims Children presenting with CSE are commonly referred to PICU for ongoing care. Limited data is available on their outcome. Objectives: 1. To determine mortality and short-term morbidity of children admitted to a regional PICU with CSE. 2. To identify differences in outcome for those with preexisting epilepsy compared to non-epileptics. Methods A retrospective cohort study of 57 children (1 month to 16 years) admitted to a regional PICU between January 2008 and December 2011 with CSE was carried out. Study population were divided into Group 1 (n=23, presence of pre-existing epilepsy) and Group 2 (n=34, absence of pre-existing epilepsy). Results The results of the group 1 and 2 respectively were: Median age (months): 33 and 21.5 Male: female ratio (%): 57:43 and 76:24 Refractory seizures (>60 min) at presentation: 83% and 53% Deviation from APLS protocol for seizure control: 43% and 32% Extra doses of benzodiazepine: 50% and 91% Neurological co-morbidity:91% and 24% Median duration of PICU ventilation:18.1 hrs and 10.5 hrs Median duration of PICU stay:24.1 and 24.5 hrs Seizure control at PICU admission: 61% and 94% Midazolam infusion in PICU: 96% and 97% Neurological investigations (LP, CT/MRI Head, EEG) performed in 22% and 94% Pre-discharge neurological morbidity: 2 (aggressive behaviour, decerebrate posturing) and 1 (increased tone) No mortality identified (Table presented) Conclusion Epileptics presented frequently with refractory seizures and were ventilated longer though this didn't affect total PICU stay; non-epileptics were investigated more frequently. Morbidity (5%) was still seen though there was no mortality in our study.