Prophylactic phenobarbital administration after resolution of neonatal seizures: Survey of current practice
Prophylactic phenobarbital administration after resolution of neonatal seizures: Survey of current practice
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DOI：
10.1542/peds.2007-3278
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发表时间：
2008-10-01
期刊：
影响因子：
8
通讯作者：
Kwon, Jennifer M.
中科院分区：
文献类型：
--
作者：
Guillet, Ronnie;Kwon, Jennifer M.
OBJECTIVE.儿童神经科医生和儿科医生经常出院的新生儿与苯巴比妥治疗数周至数月，尽管没有持续的癫痫发作活动。我们进行了一项全国性的调查，以确定这种做法的变化程度。调查被发送到一个随机生成的名单，委员会认证的儿童神经学家（N = 609）和神经科医生（N = 579）。调查包括3个部分，即与总体态度和实践、特定患者情景和受访者人口统计学特征相关的问题。将所有受访者的回答汇总，并分别对儿童神经科医生和神经科医生进行了列表和分析。评估了受访者之间实践的差异以及受访者在实践中声称的苯巴比妥使用与他们对各种临床情况的回答之间的一致性。结果。收到了118名儿童神经科医生（20.7%）和125名新生儿科医生（23.1%）的回复。在实践中有很大的差异，在儿童神经学家和神经学家之间的反应频率几乎没有差异。在特定的临床情况下，医生更有可能对继续苯巴比妥治疗做出肯定的回答，而不是根据他们对总体使用频率的回答进行预测。自15年前的实践调查以来，儿童神经科医生和儿科医生报告说，新生儿癫痫发作消退后苯巴比妥治疗的频率和时间较短，尽管实践中仍存在相当大的差异。此外，医生报告的一般做法与他们对新生儿癫痫发作的具体临床病例的反应不一致。
OBJECTIVE. Child neurologists and neonatologists often discharge newborn infants with phenobarbital treatment for weeks to months despite the absence of continuing seizure activity. We conducted a national survey to determine the degree of variation in this practice.METHODS. Surveys were sent to a randomly generated list of board-certified child neurologists (N = 609) and neonatologists (N = 579). The survey consisted of 3 parts, that is, questions related to overall attitudes and practices, specific patient scenarios, and respondent demographic characteristics. Responses were tabulated and analyzed for all respondents combined and for child neurologists and neonatologists separately. Variation in practices between respondents and the consistency between the respondents' stated use of phenobarbital in practice and their answers to various clinical scenarios were evaluated.RESULTS. Responses were received from 118 child neurologists (20.7%) and 125 neonatologists (23.1%). There was wide variation in practices, with little difference in the response frequencies between child neurologists and neonatologists. Physicians were more likely to respond yes to continuation of phenobarbital treatment in a given clinical situation than would be predicted on the basis of their answers regarding overall frequency of use.CONCLUSIONS. Since the survey of practices 15 years ago, child neurologists and neonatologists are reporting less frequent and shorter phenobarbital treatment after resolution of neonatal seizures, although there remains considerable variation in practices. Moreover, what physicians report as their practice in general is inconsistent with how they respond to specific clinical cases of neonatal seizures.