Occurrence of early epilepsy in children with traumatic brain injury:a retrospective study

Background Early post-traumatic seizures(EPTS)refer to epileptic seizures occurring within one week after brain injury.This study aimed to define the risk factors of EPTS and the protective factors that could prevent its occurrence.Methods This is a single-center retrospective study in the PICU,Beijing Children's Hospital.Patients diagnosed with traumatic brain injury(TBI),admitted with and without EPTS between January 2016 and December 2020 were included in the study.Results We included 108 patients diagnosed with TBI.The overall EPTS incidence was 33.98%(35/108).The correlation between EPTS and depressed fractures is positive(P=0.023).Positive correlations between EPTS and intracranial hemorrhage and subarachnoid hemorrhage had been established(P=0.011 and P=0.004,respectively).The detection rates of EPTS in the electroencephalogram(EEG)monitoring was 80.00%.There was a significant difference in the EEG monitoring rate between the two groups(P=0.041).Forty-one(37.86%,41/108)post-neurosurgical patients were treated with prophylactic antiepileptic drugs(AEDs),and eight(19.51%,8/41)still had seizures.No statistical significance was noted between the two groups in terms of prophylactic AEDs use(P=0.519).Logistic regression analysis revealed that open craniocerebral injury and fever on admission were risk factors for EPTS,whereas,surgical intervention and use of hypertonic saline were associated with not developing EPTS.Conclusions Breakthrough EPTS occurred after severe TBI in 33.98%of pediatric cases in our cohort.This is a higher seizure incidence than that reported previously.Patients with fever on admission and open craniocerebral injuries are more likely to develop EPTS.

Applications of mPCR testing reduced initial antibiotic use and duration of mechanical ventilation in virus-infected children with severe community-acquired pneumonia admitted to the PICU

Community-acquired pneumonia(CAP)remains the leading cause of morbidity and mortality among children worldwide.It is critical for these patients to select and timely initiate appropriate empirical antimicrobial therapy against the causative pathogens[1].However,conventional pathogen-detecting methods,such as culture and serology,have no prospect of altering empiric therapy owing to their time delay in obtaining results and to their lower detection rates[2].Recent advances in molecular diagnostic assays,such as multiplex polymerase chain reaction PCR(mPCR)methods,have been used to detect multiple pathogens in CAP simultaneously within two hours and have dramatically improved the ability to diagnose respiratory pathogens[3].However,whether this molecular diagnosis method can reduce the use of antibiotics and can improve prognosis in severe CAP children,especially those less than 5 years old,remains to be explored.