title: Standardized Treatment of Neonatal Status Epilepticus Improves Outcome.
abstract: We aimed to decrease practice variation in treatment of neonatal status epilepticus by implementing a standardized protocol. Our primary goal was to achieve 80% adherence to the algorithm within 12 months. Secondary outcome measures included serum phenobarbital concentrations, number of patients progressing from seizures to status epilepticus, and length of hospital stay. Data collection occurred for 6 months prior and 12 months following protocol implementation. Adherence of 80% within 12 months was partially achieved in patients diagnosed in our hospital; in pretreated patients, adherence was not achieved. Maximum phenobarbital concentrations were decreased (56.8 vs 41.0 µg/mL), fewer patients progressed from seizures to status epilepticus (46% vs 36%), and hospital length of stay decreased by 9.7 days in survivors. In conclusion, standardized, protocol-driven treatment of neonatal status epilepticus improves consistency and short-term outcome.
authors: Department of Neurology, Division of Child Neurology, Indiana University, School of Medicine, Indianapolis, IN, USA.
authors: Mandy L
authors: ML
authors: Harris
authors: Department of Clinical Pharmacy, Riley Hospital for Children at Indiana University Health, Indianapolis, IN, USA.
authors: Katherine M
authors: KM
authors: Malloy
authors: Neonatal Intensive Care Unit, Riley Hospital for Children at Indiana University Health, Indianapolis, IN, USA.
authors: Sheena N
authors: SN
authors: Lawson
authors: Department of Pediatrics, Division of Neonatology, Indiana University School of Medicine, Indianapolis, IN, USA.
authors: Rebecca S
authors: RS
authors: Rose
authors: Department of Clinical Pharmacy, Riley Hospital for Children at Indiana University Health, Indianapolis, IN, USA.
authors: William F
authors: WF
authors: Buss
authors: Department of Pediatrics, Division of Neonatology, Indiana University School of Medicine, Indianapolis, IN, USA umietzsc@iu.edu.
authors: Ulrike
authors: U
authors: Mietzsch
mesh_terms: D000927:Anticonvulsants / Q000097:blood / Q000627:therapeutic use; D003422:Critical Care / Q000592:standards*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007902:Length of Stay; D008297:Male; D010634:Phenobarbital / Q000097:blood / Q000627:therapeutic use; D058996:Quality Improvement; D012189:Retrospective Studies; D012640:Seizures / Q000097:blood / Q000628:therapy; D013226:Status Epilepticus / Q000097:blood / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D010634:Phenobarbital
keywords: neonatal neurocritical care; neonatal status epilepticus; quality improvement; treatment guideline