About this trial
Seizures are common in children (\~350 per 100,000 patients per year) and require immediate medical attention. If the seizure is prolonged (\> 5 minutes) it is called status epilepticus and delayed treatment leads to higher risk in drug resistance and brain injury. The current standard of care for children admitted to the ICU with established or suspected status epilepticus is to start a conventional continuous EEG study that helps diagnosing seizures by typical electro graphic patterns. It takes on average 4 hours to start and another two hours to obtain a reading by epileptologists. This is far beyond the time window of starting an EEG study (60 minutes) as recommended by the neurocritical care society. In adult ICUs, point of care "Rapid Response EEG" are becoming a new standard of care and our ICU adopted this practice in 2020. It can be easily placed by the ICU staff rather than a specifically trained EEG technician but has a lower resolution due to fewer leads (10 vs. 20). The purpose of this study is to determine wether and by how much time RR-EEG yields faster preliminary EEG reports that the previously available conventional EEG (cEEG) and wether the detection of electro graphic seizures is comparable. This is a retrospective cohort study following patients who are admitted to the PICU and are placed on either cEEG or RR-EEG for status epilepticus.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
all patients with suspected status epilepticus as determined by the treating team in the pediatric ER or ICU
Disqualifiers
none
Trial population
Pediatric patients with diminished level of consciousness and high suspicion for (non-convulsive) status epilepticus
Trial design
Cohort
Retrospective
Treatments tested in this trial
Rapid Response EEG
DeviceThe Ceribell(R) Rapid Response EEG is a relatively new device that is becoming standard of care in the adult critical care. In this pediatric study the device will be placed by trained ICU physicians
Treatment groups
Trial outcomes
Primary outcomes
Time from order of electroencephalogram (EEG) to EEG reading
EMR order placement as a surrogate for decision making to obtain an EEG. Report time of EEG was considered the time relevant information was available to the ICU team.
Secondary outcomes
Time from EEG order to start of EEG recording
time from EEG order to actual EEG start as time stamped in the EEG record
Time from EEG start to first EEG reading report as documented in the electronic medical record
time from EEG start to available EEG report
EEG description
Electrographic seizures (and burden = time spent in electro graphic seizure), brief (ictal) rhythmic discharges (BIRDs), sporadic epileptiform discharges, generalized or lateralized rhythmic delta activity (GRDA/LRDA), generalized, lateralized or bilateral independent periodic discharges (GPD/LPD/BIPD) and background reactivity, frequency, and superimposed rhythmic, fast or sharp activity ("plus factors")
Sponsors and contacts
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