Continuous Infusion Pentobarbital for Refractory Status Epilepticus in Children
Continuous Infusion Pentobarbital for Refractory Status Epilepticus in Children
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DOI：
10.1177/0883073811424941
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发表时间：
2012-06-01
影响因子：
1.9
通讯作者：
Dobyns, Emily L.
中科院分区：
文献类型：
--
作者：
Barberio, Michael;Reiter, Pamela D.;Dobyns, Emily L.
本回顾性病历综述的目的是描述接受持续戊巴比妥治疗难治性癫痫持续状态的儿童的给药方案和结局。30例患者（年龄= 6.5 ± 5.1岁; 67%为男性）接受平均负荷剂量5.4 ± 2.8 mg/kg，初始输注剂量为1.1 ± 0.4 mg/kg/h。最大输注剂量为4.8 +/- 2 mg/kg/h。33%的患者实现了持续的爆发抑制而没有复发; 66.7%的患者经历了复发，但其中60%（n = 12）最终重新实现了爆发抑制。在戊巴比妥开始后24小时内达到爆发抑制的儿童和5岁以上的儿童有积极结局的可能性高1.5倍。然而，这些变量均未达到显著性（Fisher精确检验）。93%的患者需要正性肌力药; 66%的患者感染; 10%的患者有代谢性酸中毒; 10%的患者发生胰腺炎。在33%的患者中观察到不良结局（死亡、脑病）。
The purpose of this retrospective medical chart review was to describe dosing regimens and outcomes in children who received continuous pentobarbital therapy for refractory status epilepticus. Thirty patients (age = 6.5 +/- 5.1 years; 67% male) received a mean loading dose of 5.4 +/- 2.8 mg/kg with an initial infusion of 1.1 +/- 0.4 mg/kg/h. Maximum infusion dose was 4.8 +/- 2 mg/kg/h. Thirty-three percent of patients achieved sustained burst suppression without relapse; 66.7% experienced relapse, but 60% of those (n = 12) eventually reachieved burst suppression. Children achieving burst suppression within 24 hours of pentobarbital initiation and those older than age 5 years were 1.5 times more likely to have a positive outcome. None of these variables, however, achieved significance (Fisher exact test). Ninety-three percent of patients required inotropes; 66% acquired an infection; 10% had metabolic acidosis; and 10% experienced pancreatitis. Poor outcomes (death, encephalopathy) were observed in 33% of patients.