TY - JOUR
T1 - Management of status epilepticus in childhood
T2 - a survey conducted at pediatric hospitals in the City of Buenos Aires
AU - Nuñez, Pedro
AU - Hansen, Jimena
AU - Aprea, Valeria
AU - Ricciardi, María B.Álvarez
AU - Oviedo, Silvana
AU - Fustiñana, Ana
AU - Rino, Pedro
AU - Loncarica, Guillermo Kohn
AU - Piantino, Juan
N1 - Publisher Copyright:
© 2023 Sociedad Argentina de Pediatria. All rights reserved.
PY - 2023/4
Y1 - 2023/4
N2 - Introduction. Status epilepticus is the most common neurological emergency. Although mortality in children is low, morbidity may exceed 20%. Objective. To evaluate the management of status epilepticus by pediatricians who usually treat this condition. Population and methods. Descriptive, cross-sectional study based on a survey administered to physicians from 3 pediatric hospitals in the City of Buenos Aires. Results. A total of 292 surveys were administered (complete response rate as high as 86%); 77% were administered to pediatricians and 16% to intensive care specialists. Forty-seven percent of the participants reported that they administer the first dose of a benzodiazepine within the correct timeframe; 56% use intrarectal diazepam when intravenous access is not available; 95% choose lorazepam as the initial benzodiazepine if an intravenous access is available; 58% initiate the administration of a second-line drug within the correct timeframe; 84% administer phenytoin as the first-choice, second-line drug; and 33% do not measure treatment time. Overall adherence to international recommendations was 17%. Conclusions. Our study highlights poor adherence of pediatricians to international guidelines, particularly in time-dependent decisions. Greater heterogeneity was observed in treatment approaches as the treatment algorithm progressed.
AB - Introduction. Status epilepticus is the most common neurological emergency. Although mortality in children is low, morbidity may exceed 20%. Objective. To evaluate the management of status epilepticus by pediatricians who usually treat this condition. Population and methods. Descriptive, cross-sectional study based on a survey administered to physicians from 3 pediatric hospitals in the City of Buenos Aires. Results. A total of 292 surveys were administered (complete response rate as high as 86%); 77% were administered to pediatricians and 16% to intensive care specialists. Forty-seven percent of the participants reported that they administer the first dose of a benzodiazepine within the correct timeframe; 56% use intrarectal diazepam when intravenous access is not available; 95% choose lorazepam as the initial benzodiazepine if an intravenous access is available; 58% initiate the administration of a second-line drug within the correct timeframe; 84% administer phenytoin as the first-choice, second-line drug; and 33% do not measure treatment time. Overall adherence to international recommendations was 17%. Conclusions. Our study highlights poor adherence of pediatricians to international guidelines, particularly in time-dependent decisions. Greater heterogeneity was observed in treatment approaches as the treatment algorithm progressed.
KW - pediatricians, treatment
KW - status epilepticus
KW - surveys and questionnaires
KW - the City of Buenos Aires
UR - http://www.scopus.com/inward/record.url?scp=85151043694&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85151043694&partnerID=8YFLogxK
U2 - 10.5546/aap.2022-02696.eng
DO - 10.5546/aap.2022-02696.eng
M3 - Article
C2 - 36413061
AN - SCOPUS:85151043694
SN - 0325-0075
VL - 121
JO - Archivos Argentinos de Pediatria
JF - Archivos Argentinos de Pediatria
IS - 2
M1 - e202202696
ER -