Continuous EEG monitoring in critically ill children and prognostic factors for short-term outcome: An observational study

INTRODUCTION: To evaluate the association of etiology, cEEG findings and neuroimaging findings with short-term outcome for patients admitted to PICU for acute encephalopathy.
METHODS: A total of 24 children admitted to PICU for acute encephalopathy were taken into study. Etiology, treatment, duration of stay in PICU, demographic information and past medical history were recorded. cEEG was initiated as quickly as possible following admission to PICU and continued for at least 24 hours. The short-term prognosis was evaluated by Pediatric Cerebral Performance Category score (PCPC) at PICU discharge.
RESULTS: The most common cause was traumatic brain injury (TBI) consisting 25% (n=6) of all cases. Other common causes were asphyxia (hanging, foreign body aspiration, drowning) (n=4, 16,67%) and intoxication (n=3, 12.5%). 22 patients undergone cranial imaging. The most common findings in CT were hemorrhage (n=6, 30%) and ischemia/edema (n=6, 30%). Fourteen patients had unfavorable PCPC outcome scores. There was a tendency for poorer outcome in patients with hemorrhage/ fracture or ischemia/ edema in imaging and patients either who needed pre-hospital CPR or had non-convulsive seizures without statistical significance.
DISCUSSION AND CONCLUSION: cEEG in critically ill children is useful for detecting both epileptic and non-epileptic events. The use of cEEG in PICU would be helpful for better management of cases.