Standardized Treatment of Neonatal Status Epilepticus Improves Outcome

We aimed to decrease practice variation in treatment of neonatal status epilepticus by implementing a standardized protocol. Our primary goal was to achieve 80% adherence to the algorithm within 12 months. Secondary outcome measures included serum phenobarbital concentrations, number of patients pro...

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Bibliographic Details
Published in:Journal of child neurology 2016-12, Vol.31 (14), p.1546-1554
Main Authors: Harris, Mandy L., Malloy, Katherine M., Lawson, Sheena N., Rose, Rebecca S., Buss, William F., Mietzsch, Ulrike
Format: Article
Language:English
Subjects:
Anticonvulsants - blood
Anticonvulsants - therapeutic use
Critical Care - standards
Female
Guideline Adherence
Humans
Infant, Newborn
Intensive Care Units, Neonatal
Length of Stay
Male
Phenobarbital - blood
Phenobarbital - therapeutic use
Quality Improvement
Retrospective Studies
Seizures - blood
Seizures - therapy
Status Epilepticus - blood
Status Epilepticus - therapy
Treatment Outcome
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Summary:We aimed to decrease practice variation in treatment of neonatal status epilepticus by implementing a standardized protocol. Our primary goal was to achieve 80% adherence to the algorithm within 12 months. Secondary outcome measures included serum phenobarbital concentrations, number of patients progressing from seizures to status epilepticus, and length of hospital stay. Data collection occurred for 6 months prior and 12 months following protocol implementation. Adherence of 80% within 12 months was partially achieved in patients diagnosed in our hospital; in pretreated patients, adherence was not achieved. Maximum phenobarbital concentrations were decreased (56.8 vs 41.0 µg/mL), fewer patients progressed from seizures to status epilepticus (46% vs 36%), and hospital length of stay decreased by 9.7 days in survivors. In conclusion, standardized, protocol-driven treatment of neonatal status epilepticus improves consistency and short-term outcome.
ISSN:0883-0738
1708-8283
DOI:10.1177/0883073816664670