Occurrence and risk factors associated with seizures in infants with severe bronchiolitis

被引:3
作者
Huguet, Annabelle [1 ]
Valla, Frederic [1 ]
Toulouse, Joseph [2 ]
Javouhey, Etienne [1 ]
Baudin, Florent [1 ,3 ]
机构
[1] Hosp Civils Lyon, Hop Femme Mere Enfant, Reanimat Pediat, F-69500 Bron, France
[2] Hosp Civils Lyon, ERN EpiCare, Epileptol Sleep Disorders & Funct Paediat Neurol, F-69500 Bron, France
[3] Univ Lyon, VetAgro Sup, Agress Pulm & Circulatoires Sepsis APCSe, F-69280 Marcy Letoile, France
关键词
Viral bronchiolitis; Seizure; Mechanical ventilation; Hyponatremia;
D O I
10.1007/s00431-021-04070-7
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Neurological morbidity is a growing concern in children with severe bronchiolitis. The aim of the study was to evaluate the frequency of occurrence and the factors associated with seizures in very young infants < 3 months of age, admitted to a pediatric intensive care unit (PICU) for severe bronchiolitis. We performed a single center retrospective cohort study evaluating occurrence of seizures in infants admitted to the PICU between 2010 and 2018 for severe bronchiolitis. We described characteristics of the patients, laboratory test, brain imaging, and electroencephalogram results, as well as the treatment used. We conducted a multivariable logistic regression to identify factors associated with the occurrence of seizures. A p value < 0.05 was considered significant. A total of 805 patients were included in the study; 722 (89.6%) were mechanically ventilated. Twenty-six infants (3.2%, 95% confidence interval, 95% CI [2.1%; 4.7%]) had seizures shortly prior to admission or during PICU stay. In the multivariable analysis, hyponatremia (odds ratio, OR: 4.6, 95%CI [1.86; 11.43], p = 0.001) and invasive ventilation (OR: 2.6, 95% CI [1.14; 5.9], p < 0.001) were associated with an increased likelihood of seizures occurrence. Conclusion: Seizures occur in at least 3% of very young infants with severe bronchiolitis, and the characteristics of these are different to those experienced by older infants, but they shared the same risk factors (hyponatremia and mechanical ventilation). This highlights the extrapulmonary morbidity associated with bronchiolitis in this population. What is Known: center dot Bronchiolitis is the leading cause of pediatric intensive care admission and use of mechanical ventilation in infants. center dot Neurological morbidities have to be investigated in this population at risk of neurological complications. What is New: center dot Seizure is a complication in at least 3% of very young infants with severe bronchiolitis. center dot Seizure characteristics are different, but the main risk factors are the same than in older infants (hyponatremia and mechanical ventilation).
引用
收藏
页码:2959 / 2967
页数:9
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