Abstract：
Treatment guidelines for the management of pediatric status epilepticus (PSE) are often institution-specific. We aim to characterize deviation from our hospital-based PSE treatment guidelines, the total dosage of benzodiazepines administered, and the need for intubation. The study population included all patients with an ICD -10 code for PSE who required admission to the Pediatric Intensive Care Unit (PICU) from April 2019 to April 2022. There were 66 PICU admissions. All patients with concern for PSE and altered mental status are admitted to the PICU. The cohort was divided between those treated according to the PSE protocol (benzodiazepine dose (0.05 mg/kg- 0.2 mg/kg) versus those who had low dose (≤0.05 mg/kg) and high-dose benzodiazepine (> 0.2 mg/kg) totals. The dosage was calculated as the total dose of benzodiazepines received pre-hospital and in the ED before intubation or transport. Forty-one (62 %) of patients received high-dose benzodiazepines (median 0.34 mg/kg [IQR 0.29-0.56], 19 (29 %) received recommended-dose benzodiazepines (median 0.13 mg/kg [IQR 0.09,0.15] and 6 (9 %) received low-dose (median 0.05 mg/kg [IQR 0.03,0.05]. The high-dose group was 15.9 (95 % CI = 3.7, 99.9) times more likely to be intubated controlling for the location of care (tertiary versus community hospital), and the age of the patient. The recommended-dose and low-dose groups required intubation with much less frequency.
摘要：
儿科癫痫持续状态（PSE）的治疗指南通常是针对机构的。我们的目标是描述与我们基于医院的PSE治疗指南的偏差，苯二氮卓类药物的总剂量，以及插管的需要。研究人群包括2019年4月至2022年4月需要进入儿科重症监护病房（PICU）的所有PSEICD-10代码患者。有66名PICU入院。所有患有PSE和精神状态改变的患者均进入PICU。队列分为根据PSE方案治疗的患者（苯二氮卓剂量（0.05mg/kg-0.2mg/kg）与低剂量（≤0.05mg/kg）和高剂量苯二氮卓（>0.2mg/kg）的患者。剂量计算为入院前和插管或运输前在ED中接受的苯二氮卓类药物的总剂量。41例（62%）患者接受高剂量苯二氮卓类药物（中位数0.34mg/kg[IQR0.29-0.56]，19例（29%）接受推荐剂量的苯二氮卓类药物（中位数为0.13mg/kg[IQR0.09,0.15]，6例（9%）接受低剂量（中位数为0.05mg/kg[IQR0.03,0.05]。高剂量组是15.9（95％CI=3.7，99.9）倍，更可能是控制护理位置的插管（三级医院与社区医院），以及病人的年龄。推荐剂量组和低剂量组需要插管的频率要少得多。
