Introduction - Objective: Seizures can lead to organ damage, cardiopulmonary arrest, permanent neurological damage, and death. Patients presenting to the Pediatric Emergency Department (ED) with uncontrolled seizures often require tracheal intubation (TI). We aimed to examine the factors associated with the requirement of TI in pediatric patients with uncontrolled seizures. Methods: We conducted a single-center retrospective study. We reviewed the medical records of fifty-six patients aged <1 year to 21 who presented to the pediatric ED with uncontrolled seizures. We grouped patients into intubated and not intubated and analyzed the clinical and demographic characteristics by group. We compared the probability of TI given a particular underlying seizure etiology. We calculated the trend between the duration of seizures and the number of medications with the probability of intubation. Results: Forty-six percent of patients (26/56) required TI. The most common cause for seizures in the intubated group was complex febrile seizures (7/26). Fourteen out of 26 patients were intubated for airway protection, and 11/26 patients were intubated for respiratory failure. There is a linear trend between increasing duration of seizures and chances of intubation (p= .035). Longer seizures (10-60 min) increased the odds of intubation by 4.2 times [95% CI 1.2, 14.4]. Conclusions: In our cohort of patients who presented to the ED with uncontrolled seizures, those requiring tracheal intubation were most frequently complex febrile convulsions. Longer seizures increased the risk for TI, and poly-drug therapy was typically needed for seizure control.

Mugdha Mohanty
University of Massachusetts (UMASS)
United States

Zakir Shaikh
University of Massachusetts (UMASS)
United States

Shivangi Kataria
Syneos Health
United States

Juan Diego Vega Gonzales-Portillo
Boston University Aram V. Chobanian & Edward Avedisian School of Medicine
United States

Danna P. Garcia-Guaqueta
Boston University Aram V. Chobanian & Edward Avedisian School of Medicine
United States

Alcy R. Torres
Boston University Aram V. Chobanian & Edward Avedisian School of Medicine
United States