KẾT CỤC VÀ ĐIỆN THẾ NỀN QUA ĐIỆN NÃO ĐỒ TÍCH HỢP BIÊN ĐỘ (AEEG) Ở TRẺ RỐI LOẠN TRI GIÁC TẠI KHOA HỒI SỨC NHIỄM - BỆNH VIỆN NHI ĐỒNG 1

Abstract

Objectives: Altered consciousness (AC) is a common condition in pediatric intensive care units (PICUs) and is associated with high mortality rates. Amplitude-integrated electroencephalography (aEEG) is a simple bedside monitoring tool that helps detect non-convulsive seizures (NCS), non-convulsive status epilepticus (NCSE), and continuously assess brain function. This approach is of great importance in guiding timely interventions and improving neurological outcomes in critically ill children. This study aimed to describe the characteristics of aEEG patterns and treatment outcomes among children with altered consciousness in the Infectious Diseases Intensive Care Unit, Children’s Hospital 1. Methods: A descriptive study was conducted on 40 pediatric patients aged from 1 month to under 16 years who presented with altered consciousness and were admitted to the Infectious Diseases Intensive Care Unit, Children’s Hospital 1, from January 2024 to June 2025. Data were collected during aEEG recordings lasting at least 48 hours. Results: Among 40 patients with altered consciousness, the leading causes were encephalitis and meningitis (75%). Abnormal background activity on aEEG was observed in 45% of cases at the end of monitoring and was significantly associated with unfavorable outcomes (death or severe neurological sequelae) (p < 0.05). Severely abnormal patterns (LV and FT types) accounted for 20%. According to Sewell’s classification, 15% of patients showed persistently severely abnormal backgrounds, while 10% progressed from continuous or discontinuous normal voltage (CNV, DNV) to burst suppression (BS), low voltage (LV), or flat trace (FT). Seizures on aEEG were detected in 24 patients compared to 22 with clinically observed seizures. The mortality rate in the cohort was 25%. Conclusions: Amplitude-integrated EEG is a useful bedside tool for detecting subclinical seizures and evaluating brain function in pediatric patients with altered consciousness. Abnormal background patterns on aEEG were significantly associated with poor outcomes.