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Impact of timing of continuous intravenous anesthetic drug treatment on outcome in refractory status epilepticus

Impact of timing of continuous intravenous anesthetic drug treatment on outcome in refractory status epilepticus

Patients with refractory status epilepticus (RSE) treated with continuous intravenous anesthetic drugs (cIVADs) may benefit from early initiation of such therapy. wWhen cIVADs are applied in RSE, prescribing them early may positively impact outcome, probably by shorter seizure duration and apparently mainly in those patients who do not have a severe RSE etiology dominating their prognosis. Fifty-three (68.8%) patients received cIVADs within the first 48 h. Early cIVAD treatment was independently associated with good outcome (adjusted risk ratio [aRR] 3.175, 95% confidence interval [CI] 1.273–7.918; P = 0.013) as well as lower chance of both induction of burst suppression (aRR 0.661, 95% CI 0.507–0.861; P = 0.002) and use of thiopental (aRR 0.446, 95% CI 0.205–0.874; P = 0.043). This was a retrospective cohort study over 14 years (n = 77) comparing patients with RSE treated with cIVADs within and after 48 h after RSE onset, and functional status at last follow-up was the primary outcome (good = return to premorbid baseline or modified Rankin Scale score of less than 3).

CriticalCare.news
November 28, 2018