The following is a summary of “A Comparison of Treatment Practices for Newborn Seizure Management Across Level II and III Neonatal Intensive Care Units in the United States,” published in the September 2024 issue of Pediatrics by Dickman et al.
Neonatal seizures (NS) are a significant clinical concern in critically ill infants, often indicating underlying brain injury and necessitating prompt intervention to minimize long-term morbidity and mortality. This study aimed to evaluate the management strategies and treatment protocols for neonatal seizures employed by Level II/III neonatal intensive care units (NICUs) across the United States, focusing on identifying consensus and variability in practice. An electronic survey was administered to personnel at 51 NICUs, querying aspects such as access to neurology specialists, on-site electroencephalography (EEG) monitoring, and the availability and utilization of anti-seizure medications.
Results revealed that only 25% of NICUs had a formal clinical practice pathway for managing neonatal seizures, while 24% had written guidelines defining “neonatal seizures.” Although most NICUs reported having phenobarbital available for immediate seizure management, there was a notable scarcity of additional anti-seizure medications for escalation of treatment. Furthermore, 24% of NICUs lacked on-site EEG monitoring capabilities, and access to neurology consultants was limited and inconsistent, both during the day and overnight. These findings highlight significant disparities in the resources available for managing neonatal seizures.
The study underscores the need for developing and implementing standardized protocols that enhance the accessibility of EEG monitoring and facilitate timely neurology consultations. Addressing these gaps could lead to more effective detection, evaluation, and management of seizures in neonates, ultimately improving patient outcomes and reducing the risk of long-term complications.
Source: sciencedirect.com/science/article/abs/pii/S088789942400331X
