Benzodiazepine administration patterns before escalation to second-line medications in pediatric refractory convulsive status epilepticus
| Autor: | Adam P. Ostendorf, Linda Huh, Raquel Farias-Moeller, Edward J. Novotny, Bo Zhang, Latania Reece, Cristina Barcia Aguilar, Katrina Peariso, Renée A. Shellhaas, Robert J. Kahoud, Tracy A. Glauser, Howard P. Goodkin, Ravindra Arya, Michele Jackson, Tristan T. Sands, Robert C. Tasker, Alejandra Vasquez, Tobias Loddenkemper, Mohamad A. Mikati, Nicholas S. Abend, Angus Wilfong, Alexis A. Topjian, Tiffani L McDonough, Juan Piantino, Dmitry Tchapyjnikov, Joshua L. Goldstein, Yi-Chen Lai, Eric T. Payne, Kumar Sannagowdara, J. Nicholas Brenton, Réjean M. Guerriero, Anne E. Anderson, Brian Appavu, Garnett C. Smith, Lindsey A. Morgan, William D. Gaillard, James J. Riviello, Kush Kapur, Kevin E. Chapman, Justice Clark, Marina Gaínza-Lein, Theodore Sheehan, Marta Amengual-Gual, Mark S. Wainwright, Jessica L. Carpenter, Korwyn Williams |
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| Rok vydání: | 2021 |
| Předmět: |
Pediatrics
medicine.medical_specialty Drug Resistant Epilepsy medicine.drug_class Status epilepticus Rate ratio Epilepsy Benzodiazepines Status Epilepticus Refractory Interquartile range Seizures medicine Humans Risk factor Child Retrospective Studies Benzodiazepine business.industry medicine.disease Confidence interval Neurology Child Preschool Anticonvulsants Neurology (clinical) medicine.symptom business |
| Zdroj: | Epilepsia. 62(11) |
| ISSN: | 1528-1167 |
| Popis: | OBJECTIVE This study was undertaken to evaluate benzodiazepine (BZD) administration patterns before transitioning to non-BZD antiseizure medication (ASM) in pediatric patients with refractory convulsive status epilepticus (rSE). METHODS This retrospective multicenter study in the United States and Canada used prospectively collected observational data from children admitted with rSE between 2011 and 2020. Outcome variables were the number of BZDs given before the first non-BZD ASM, and the number of BZDs administered after 30 and 45 min from seizure onset and before escalating to non-BZD ASM. RESULTS We included 293 patients with a median (interquartile range) age of 3.8 (1.3-9.3) years. Thirty-six percent received more than two BZDs before escalating, and the later the treatment initiation was after seizure onset, the less likely patients were to receive multiple BZD doses before transitioning (incidence rate ratio [IRR] = .998, 95% confidence interval [CI] = .997-.999 per minute, p = .01). Patients received BZDs beyond 30 and 45 min in 57.3% and 44.0% of cases, respectively. Patients with out-of-hospital seizure onset were more likely to receive more doses of BZDs beyond 30 min (IRR = 2.43, 95% CI = 1.73-3.46, p |
| Databáze: | OpenAIRE |
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