Abstract Details

Title Induced Hypothermia/Normothermia with General Anesthesia Is Related to Better Outcomes in Children with Acute Encephalopathy Caused by Excitotoxicity

Topic Critical Care/Emergency Neurology/Trauma

Presentation(s) P05 - (-)

Poster/Presentation
Number 198

Objective

Background BACKGROUND: Acute encephalopathy is one of the most important causes of mortality and neurological sequelae in children. There have been no studies on the efficacies of treatments for acute encephalopathy in children, even though hypothermia has been shown to be effective for treating influenza in some children with encephalopathy.

Design/Methods DESIGN/METHODS: We retrospectively evaluated the clinical courses and outcomes of 57 consecutive children with acute encephalopathy that was caused by excitotoxicity between October 2002 and August 2011. The inclusion criteria consisted of the following: (1) seizure with fever (?38.0[deg]C) with or without convulsions and (2) refractory status epilepticus (RSE) and/or prolonged neurological abnormalities with Glasgow Coma Scale scores less than 15 or paralysis 6 h after onset. Nine children with acute encephalopathy due to metabolic error or cytokine storm were excluded. We compared the clinical characteristics and neurological outcomes of children treated with H/N therapy and other therapy. H/N therapy was defined as temperature control (34[deg]C-36[deg]C) with the continuous use of anticonvulsants and muscle relaxants within 24 h of onset. Outcome was measured by the Pediatric Cerebral Performance Category (PCPC) Scale with a grade of 1 representing a good clinical outcome and grades of 2-6 considered to represent a poor outcome.

Results RESULTS: Outcomes were good in all 23 children treated with H/N therapy, whereas they were poor in 10 of 34 children treated with other therapies (p = 0.004). There were no significant differences in age, gender, the RSE rate, the prolonged neurologic abnormality rate, the preceding infection rate, and laboratory data between children treated with H/N therapy and those treated with other therapies.

Conclusions CONCLUSIONS: H/N therapy is related to better outcomes in children with acute encephalopathy caused by excitotoxicity.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
Jeffrey A. Cohen, MD (Cleveland Clinic)	Dr. Cohen has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Convelo. Dr. Cohen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Astoria. Dr. Cohen has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Bristol Myers Squibb. Dr. Cohen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Viatris. Dr. Cohen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for PSI. Dr. Cohen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shionogi. Dr. Cohen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Celltrion.
	No disclosure on file
Hiroaki Nagase, MD, PhD (Kobe University Hospital)	No disclosure on file

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