Department of Radiology, Shenzhen Children's Hospital, Shenzhen, China.
Department of Pediatric Intensive Care Unit, Shenzhen Children's Hospital, Shenzhen, China.
Pediatr Res. 2023 Mar;93(4):755-762. doi: 10.1038/s41390-022-02187-5. Epub 2022 Jul 29.
To investigate the incidence of seizures and short-term mortality associated with seizures in children undergoing extracorporeal membrane oxygenation (ECMO).
PubMed, Embase, and Web of Science were searched from inception to September 2021. Study quality was assessed using the Newcastle-Ottawa Scale. Random effects meta-analysis was conducted.
Fourteen studies met the inclusion criteria for quantitative meta-analysis. The cumulative estimate of seizure incidence was 15% (95% CI: 12-17%). Studies using electroencephalography reported a higher incidence of seizures compared with those using electro-clinical criteria (19% vs. 9%, P = 0.034). Furthermore, 75% of seizures were subclinical. Children receiving extracorporeal cardiopulmonary resuscitation (ECPR) exhibited a higher incidence of seizures compared to children with respiratory and cardiac indications. Seizure incidence was higher in patients undergoing venoarterial (VA) ECMO compared with venovenous (VV) ECMO. The pooled odds ratio of mortality was 2.58 (95% CI: 2.25-2.95) in those developed seizures.
The incidence of seizures in children requiring ECMO was 15% and majority of seizures were subclinical. The incidence of seizures was higher in patients receiving ECPR than in those with respiratory and cardiac indications. Seizures were more frequent in patients undergoing VA ECMO than VV ECMO. Seizures were associated with increased short-term mortality.
The incidence of seizures in children undergoing extracorporeal membrane oxygenation (ECMO) was ~15% and majority of the seizures were subclinical. Seizures were associated with increased short-term mortality. Risk factors for seizures were extracorporeal cardiopulmonary resuscitation and venoarterial ECMO. Electroencephalography (EEG) monitoring is recommended in children undergoing ECMO and further studies on the optimal protocol for EEG monitoring are necessary.
调查儿童体外膜氧合（ECMO）过程中癫痫发作的发生率和短期死亡率。
从建库到 2021 年 9 月，检索 PubMed、Embase 和 Web of Science。使用纽卡斯尔-渥太华量表评估研究质量。采用随机效应荟萃分析。
14 项研究符合定量荟萃分析的纳入标准。癫痫发作的累积发生率为 15%（95%CI：12-17%）。使用脑电图的研究报告的癫痫发作发生率高于使用电临床标准的研究（19%比 9%，P=0.034）。此外，75%的癫痫发作是亚临床的。与有呼吸和心脏适应证的儿童相比，接受体外心肺复苏（ECPR）的儿童癫痫发作发生率更高。与静脉-静脉（VV）ECMO 相比，静脉-动脉（VA）ECMO 的患者癫痫发作发生率更高。发生癫痫的患者的死亡率合并比值比为 2.58（95%CI：2.25-2.95）。
需要 ECMO 的儿童癫痫发作的发生率为 15%，大多数癫痫发作是亚临床的。接受 ECPR 的患者癫痫发作发生率高于有呼吸和心脏适应证的患者。VA-ECMO 的患者比 VV-ECMO 的患者更频繁发生癫痫。癫痫与短期死亡率增加相关。
儿童体外膜氧合（ECMO）过程中癫痫发作的发生率约为 15%，大多数癫痫发作是亚临床的。癫痫与短期死亡率增加相关。癫痫发作的危险因素是体外心肺复苏和静脉-动脉 ECMO。建议对接受 ECMO 的儿童进行脑电图（EEG）监测，并进一步研究 EEG 监测的最佳方案。
