早期临床变量与耐火性状态相关 儿童中的
Katrina Peariso1, Ravindra Arya2, Tracy Glauser2
1From the Department of Neurology and Physical Medicine and Rehabilitation (K.P.), University of Cincinnati College of Medicine, OH; Division of Pediatric Neurology (R.A., T.G., P.S.H.), Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, OH; Division of Neurology (N.S.A.), The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania; Division of Epilepsy and Clinical Neurophysiology (C.B.A., Justice Clark, M.G.-L., K.K., T.L.), Department of Neurology, Boston Children's Hospital, Harvard Medical School, MA; Department of Child Neurology (CBA), Hospital Universitario La Paz, Universidad Autonoma de Madrid, Spain; Pediatric Neurology Unit (M.A.-G.), Department of Pediatrics, Hospital Universitari Son Espases, Universitat de Les Illes Balears, Palma, Spain; Section of Neurology and Developmental Neuroscience (A.A., J.R.), Department of Pediatrics, Baylor College of Medicine, Houston, TX; Department of Pediatrics (B.L.A., K.E.C., A.W., K.W.), University of Arizona College of Medicine and Barrow's Neurological Institute at Phoenix Children's Hospital; Department of Neurology and Pediatrics (J.N.B., H.G.), University of Virginia Health System, Charlottesville; Division of Pediatric Neurology (Jessica Carpenter), University of Maryland School of Medicine, Baltimore; Center for Neuroscience (W.D.G.), Children's National Hospital, George Washington University School of Medicine and Health Sciences, DC; Instituto de Pediatría (M.G.-L.), Facultad de Medicina, Universidad Austral de Chile, Valdivia; Servicio de Neuropsiquiatría Infantil (M.G.-L.), Hospital Clínico San Borja Arriarán, Universidad de Chile, Santiago; Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program (J.G.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Pediatric Neurology and Epilepsy (Z.G., B.O.M.), Department of Pediatrics, Weill Cornell Medicine, New York; Division of Pediatric and Developmental Neurology (R.M.G.), Washington University School of Medicine, St. Louis, MO; Department of Pediatrics (L.H.), British Columbia Children's Hospital, the University of British Columbia, Canada; Division of Child and Adolescent Neurology (R.K., A.V.-A.), Department of Neurology, Mayo Clinic, Rochester, MN; Division of Pediatric Neurology (S.A.K., E.H.K., C.E.S.), Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD; Section of Pediatric Critical Care Medicine (Y.-C.L.), Department of Pediatrics, Baylor College of Medicine, Houston, TX; Department of Pediatrics (T.M.), Division of Neurology and Epilepsy, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, IL; Division of Pediatric Neurology (M.A.M., D.T.), Duke University Medical Center, Duke University, Durham, NC; Department of Neurology (L.M., E.N., M.S.W.), Division of Child Neurology, Seattle Children's Hospital, WA; Department of Pediatrics (A.P.O.), Nationwide Children's Hospital, The Ohio State University, Columbus; Division of Neurology (E.T.P.), Department of Pediatrics, Alberta Children's Hospital, Calgary, Canada; Division of Neurology (J.P.), Doernbecher Children's Hospital, Oregon Health & Science University, Portland; Division of Child Neurology & Institute for Genomic Medicine (T.S.), Columbia University Irving Medical Center, New York Presbyterian Hospital; and Department of Anesthesiology (R.C.T.), Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, MA. peariska@ucmail.uc.edu.
患有的家族病史或直肠药处方可能会降低儿童耐性状态 (RSE) 的风险. 这些因素,早期确定,可以帮助量身定制儿科紧急护理,以获得更好的结果.
科学领域:
- 儿科神经学 儿科神经学
- 紧急医疗 紧急医疗
- 临床研究 临床研究
背景情况:
- 抗发作性性状态 (RSE) 在儿科急诊护理中构成了重大挑战.
- 确定RSE的预测因素对于及时和有效的干预至关重要.
研究的目的:
- 确定早期紧急护理中存在的与儿童RSE发展相关的患者特异性因素.
- 为了比较具有响应性既定状态 (rESE) 和RSE的儿童之间的临床变量.
主要方法:
- 一项观察性病例控制研究比较了儿科患者 (1个月-21岁) 与rESE和RSE.
- 呈现后早期获得的临床变量使用单变量和多变量逻辑回归来分析.
- 数据来源于儿科状态发症研究小组研究队列.
主要成果:
- 在RSE和rESE组之间,在第一次使用类 (BZD) 的时间上没有显著差异.
- 在RSE组中,获得二线抗发作药物 (ASM) 的时间较短 (p=0.021).
- 的家族病史 (OR 0.37) 和直肠代谢处方 (OR 0.21) 与RSE的几率降低有关.
结论:
- 早期的临床因素,特别是家族发作史和直肠大泽帕姆处方,与RSE进展的可能性降低有关.
- 这些发现表明,这些因素的早期识别可以有助于为儿科发作提供量身定制的护理.
- 第二类证据表明,患者和临床因素可以预测儿童的RSE.
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