Use of midazolam for refractory status epilepticus in children
Morbidity and mortality are high in children with refractory status epilepticus (RSE). Here, we assess the efficacy of midazolam for RSE in children. This was a retrospective analysis of 29 children admitted to the Lille University Hospital pediatric intensive care unit (PICU) for RSE between May 20...
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| Veröffentlicht in: | Revue neurologique 2010-06, Vol.166 (6-7), p.648-652 |
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| creator | Lampin, M-E Dorkenoo, A Lamblin, M-D Botte, A Leclerc, F Auvin, S |
| description | Morbidity and mortality are high in children with refractory status epilepticus (RSE). Here, we assess the efficacy of midazolam for RSE in children.
This was a retrospective analysis of 29 children admitted to the Lille University Hospital pediatric intensive care unit (PICU) for RSE between May 2006 and July 2008. The onset of the study corresponded with a new therapeutic protocol applied in the PICU for RSE where midazolam was proposed as the first-line treatment (bolus ten continuous infusion until control) to be replaced by thiopenthal in case of failure.
We recorded 29 patients with RSE during the study period: 26 were treated with midazolam, including two where midazolam replaced thiopenthal because of hypotension. Midazolam successfully controlled RSE in 58% of patients. Mean delay to cessation of RSE was 48+/-65 minutes. Hypotension was observed in 8% of midazolam-treated patients and 71% of thiopenthal-treated patients. Overall mortality was 15% (4/26). Two deaths occurred long after the cessation of RSE. None of the deaths occurred in midazolam-treated patients.
Midazolam is an efficient treatment for RSE in children. Morbidity and mortality appear to be lower with midazolam compared with other antiepileptic drugs used for the treatment of RSE. |
| doi_str_mv | 10.1016/j.neurol.2009.12.009 |
| format | Article |
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This was a retrospective analysis of 29 children admitted to the Lille University Hospital pediatric intensive care unit (PICU) for RSE between May 2006 and July 2008. The onset of the study corresponded with a new therapeutic protocol applied in the PICU for RSE where midazolam was proposed as the first-line treatment (bolus ten continuous infusion until control) to be replaced by thiopenthal in case of failure.
We recorded 29 patients with RSE during the study period: 26 were treated with midazolam, including two where midazolam replaced thiopenthal because of hypotension. Midazolam successfully controlled RSE in 58% of patients. Mean delay to cessation of RSE was 48+/-65 minutes. Hypotension was observed in 8% of midazolam-treated patients and 71% of thiopenthal-treated patients. Overall mortality was 15% (4/26). Two deaths occurred long after the cessation of RSE. None of the deaths occurred in midazolam-treated patients.
Midazolam is an efficient treatment for RSE in children. Morbidity and mortality appear to be lower with midazolam compared with other antiepileptic drugs used for the treatment of RSE.</description><identifier>ISSN: 0035-3787</identifier><identifier>DOI: 10.1016/j.neurol.2009.12.009</identifier><identifier>PMID: 20171707</identifier><language>fre</language><publisher>France</publisher><subject>Adolescent ; Catecholamines - blood ; Child ; Child, Preschool ; Female ; GABA Modulators - adverse effects ; GABA Modulators - therapeutic use ; Humans ; Hypotension - chemically induced ; Infant ; Male ; Midazolam - adverse effects ; Midazolam - therapeutic use ; Patient Acceptance of Health Care ; Retrospective Studies ; Status Epilepticus - drug therapy ; Thiopental - therapeutic use</subject><ispartof>Revue neurologique, 2010-06, Vol.166 (6-7), p.648-652</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20171707$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lampin, M-E</creatorcontrib><creatorcontrib>Dorkenoo, A</creatorcontrib><creatorcontrib>Lamblin, M-D</creatorcontrib><creatorcontrib>Botte, A</creatorcontrib><creatorcontrib>Leclerc, F</creatorcontrib><creatorcontrib>Auvin, S</creatorcontrib><title>Use of midazolam for refractory status epilepticus in children</title><title>Revue neurologique</title><addtitle>Rev Neurol (Paris)</addtitle><description>Morbidity and mortality are high in children with refractory status epilepticus (RSE). Here, we assess the efficacy of midazolam for RSE in children.
This was a retrospective analysis of 29 children admitted to the Lille University Hospital pediatric intensive care unit (PICU) for RSE between May 2006 and July 2008. The onset of the study corresponded with a new therapeutic protocol applied in the PICU for RSE where midazolam was proposed as the first-line treatment (bolus ten continuous infusion until control) to be replaced by thiopenthal in case of failure.
We recorded 29 patients with RSE during the study period: 26 were treated with midazolam, including two where midazolam replaced thiopenthal because of hypotension. Midazolam successfully controlled RSE in 58% of patients. Mean delay to cessation of RSE was 48+/-65 minutes. Hypotension was observed in 8% of midazolam-treated patients and 71% of thiopenthal-treated patients. Overall mortality was 15% (4/26). Two deaths occurred long after the cessation of RSE. None of the deaths occurred in midazolam-treated patients.
Midazolam is an efficient treatment for RSE in children. Morbidity and mortality appear to be lower with midazolam compared with other antiepileptic drugs used for the treatment of RSE.</description><subject>Adolescent</subject><subject>Catecholamines - blood</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>GABA Modulators - adverse effects</subject><subject>GABA Modulators - therapeutic use</subject><subject>Humans</subject><subject>Hypotension - chemically induced</subject><subject>Infant</subject><subject>Male</subject><subject>Midazolam - adverse effects</subject><subject>Midazolam - therapeutic use</subject><subject>Patient Acceptance of Health Care</subject><subject>Retrospective Studies</subject><subject>Status Epilepticus - drug therapy</subject><subject>Thiopental - therapeutic use</subject><issn>0035-3787</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo1j81KxDAURrNQnHH0DUSyc9V6k9Sk3Qgy-AcDbpx1uW1vMEPa1KRdjE9vwXF1zuLjwMfYjYBcgND3h3ygOQafS4AqFzJfcMbWAOohU6Y0K3aZ0gFACgPqgq0kCLOoWbPHfSIeLO9dhz_BY89tiDySjdhOIR55mnCaE6fReRon1y7uBt5-Od9FGq7YuUWf6PrEDdu_PH9u37Ldx-v79mmXjaKAKWs60-iCmtYYIbWu0C6O2gqFQredMLIosVQNqYosKE2IulBEpS4VNqDUht39dccYvmdKU9271JL3OFCYU22KsjJLRS7L29Nybnrq6jG6HuOx_r-sfgHqulks</recordid><startdate>201006</startdate><enddate>201006</enddate><creator>Lampin, M-E</creator><creator>Dorkenoo, A</creator><creator>Lamblin, M-D</creator><creator>Botte, A</creator><creator>Leclerc, F</creator><creator>Auvin, S</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>201006</creationdate><title>Use of midazolam for refractory status epilepticus in children</title><author>Lampin, M-E ; Dorkenoo, A ; Lamblin, M-D ; Botte, A ; Leclerc, F ; Auvin, S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p140t-bd7b64ebc7712669afebca6f13a16cd17248a83be39ef036eaa643ee8683ab033</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>fre</language><creationdate>2010</creationdate><topic>Adolescent</topic><topic>Catecholamines - blood</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>GABA Modulators - adverse effects</topic><topic>GABA Modulators - therapeutic use</topic><topic>Humans</topic><topic>Hypotension - chemically induced</topic><topic>Infant</topic><topic>Male</topic><topic>Midazolam - adverse effects</topic><topic>Midazolam - therapeutic use</topic><topic>Patient Acceptance of Health Care</topic><topic>Retrospective Studies</topic><topic>Status Epilepticus - drug therapy</topic><topic>Thiopental - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lampin, M-E</creatorcontrib><creatorcontrib>Dorkenoo, A</creatorcontrib><creatorcontrib>Lamblin, M-D</creatorcontrib><creatorcontrib>Botte, A</creatorcontrib><creatorcontrib>Leclerc, F</creatorcontrib><creatorcontrib>Auvin, S</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Revue neurologique</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lampin, M-E</au><au>Dorkenoo, A</au><au>Lamblin, M-D</au><au>Botte, A</au><au>Leclerc, F</au><au>Auvin, S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Use of midazolam for refractory status epilepticus in children</atitle><jtitle>Revue neurologique</jtitle><addtitle>Rev Neurol (Paris)</addtitle><date>2010-06</date><risdate>2010</risdate><volume>166</volume><issue>6-7</issue><spage>648</spage><epage>652</epage><pages>648-652</pages><issn>0035-3787</issn><abstract>Morbidity and mortality are high in children with refractory status epilepticus (RSE). Here, we assess the efficacy of midazolam for RSE in children.
This was a retrospective analysis of 29 children admitted to the Lille University Hospital pediatric intensive care unit (PICU) for RSE between May 2006 and July 2008. The onset of the study corresponded with a new therapeutic protocol applied in the PICU for RSE where midazolam was proposed as the first-line treatment (bolus ten continuous infusion until control) to be replaced by thiopenthal in case of failure.
We recorded 29 patients with RSE during the study period: 26 were treated with midazolam, including two where midazolam replaced thiopenthal because of hypotension. Midazolam successfully controlled RSE in 58% of patients. Mean delay to cessation of RSE was 48+/-65 minutes. Hypotension was observed in 8% of midazolam-treated patients and 71% of thiopenthal-treated patients. Overall mortality was 15% (4/26). Two deaths occurred long after the cessation of RSE. None of the deaths occurred in midazolam-treated patients.
Midazolam is an efficient treatment for RSE in children. Morbidity and mortality appear to be lower with midazolam compared with other antiepileptic drugs used for the treatment of RSE.</abstract><cop>France</cop><pmid>20171707</pmid><doi>10.1016/j.neurol.2009.12.009</doi><tpages>5</tpages></addata></record> |
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| ispartof | Revue neurologique, 2010-06, Vol.166 (6-7), p.648-652 |
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| language | fre |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Adolescent Catecholamines - blood Child Child, Preschool Female GABA Modulators - adverse effects GABA Modulators - therapeutic use Humans Hypotension - chemically induced Infant Male Midazolam - adverse effects Midazolam - therapeutic use Patient Acceptance of Health Care Retrospective Studies Status Epilepticus - drug therapy Thiopental - therapeutic use |
| title | Use of midazolam for refractory status epilepticus in children |
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