[P2-78] Electroencephalography as a Predictor of Mortality in Children in Intensive Care Unit and the Effect of Sedatives
We hypothesized that the electroencephalography (EEG) findings would predict mortality of the children who were admitted to the intensive care unit (ICU), and the EEG findings could be affected by continuously administered intravenous sedatives.
We reviewed EEGs of 113 pediatric patients, aged less than 18 years old, who took EEGs in the ICU for various reasons at Severance Hospital between 2012 and 2015. Those who had underlying neurologic disease or previous abnormal EEGs had been excluded. Background activities, reactivity, and interictal epileptiform discharges (IEDs) were investigated in each EEG. Background activities were scored as; 1 –normal, 2 –diffusely slow, 3 – epileptiform, 4 – burst-suppression, 5 – low-voltage, 6 – isoelectric.
Of 113, 43 (38.1%) patients died. Mortality was positively correlated with background activity on EEG (p<0.001, r=1.000), and was higher in those who did not show reactivity (p<0.001). Of 113 patients, 37 were under sedation at the time of the EEG study. In these patients, 18 patients died and we failed to find any association between mortality and EEG background score (p = 0.381) or reactivity (p = 0.604). Among 76 patients who were not under sedation, 25 patients died. In this group, the relationship between mortality and EEG background score (p < 0.001) and reactivity (p < 0.001) remained significant.
EEG background and absence of reactivity were correlated with high mortality in children who were critically ill. However, these findings should be applied with a caution since EEG findings are affected by sedatives that are commonly used in the ICU setting.
We reviewed EEGs of 113 pediatric patients, aged less than 18 years old, who took EEGs in the ICU for various reasons at Severance Hospital between 2012 and 2015. Those who had underlying neurologic disease or previous abnormal EEGs had been excluded. Background activities, reactivity, and interictal epileptiform discharges (IEDs) were investigated in each EEG. Background activities were scored as; 1 –normal, 2 –diffusely slow, 3 – epileptiform, 4 – burst-suppression, 5 – low-voltage, 6 – isoelectric.
Of 113, 43 (38.1%) patients died. Mortality was positively correlated with background activity on EEG (p<0.001, r=1.000), and was higher in those who did not show reactivity (p<0.001). Of 113 patients, 37 were under sedation at the time of the EEG study. In these patients, 18 patients died and we failed to find any association between mortality and EEG background score (p = 0.381) or reactivity (p = 0.604). Among 76 patients who were not under sedation, 25 patients died. In this group, the relationship between mortality and EEG background score (p < 0.001) and reactivity (p < 0.001) remained significant.
EEG background and absence of reactivity were correlated with high mortality in children who were critically ill. However, these findings should be applied with a caution since EEG findings are affected by sedatives that are commonly used in the ICU setting.