Propofol-ketamine combination therapy for effective control of super-refractory status epilepticus

Vivek Sabharwal; Eugene Ramsay; Raisa Martinez; Rachel Shumate; Fawad Khan; Hina Dave; Ifeanyi Iwuchukwu; Harold McGrade

doi:10.1016/j.yebeh.2015.07.040

Propofol-ketamine combination therapy for effective control of super-refractory status epilepticus

Vivek Sabharwal, Eugene Ramsay, Raisa Martinez, Rachel Shumate, Fawad Khan, Hina Dave, Ifeanyi Iwuchukwu, Harold McGrade

Research output: Contribution to journal › Article › peer-review

43 Scopus citations

Abstract

Retrospective analysis was conducted of patients with SRSE who were treated simultaneously with propofol and ketamine. Sixty-seven patients were identified from 2012 to 2015, and outcomes documented were resolution and mortality. The duration of combined ketamine and propofol use ranged from 1 to 28 days (mean - 3.6 days). Infusion rates ranged up to 145 and 175 mcg/kg/min. Vasopressors were used in 53 patients (79%), and were given within the first 5 days of the ICU admission in 48 (91%) patients. The overall SRSE resolution rate was 91%, and the overall mortality including patients with anoxic brain injury was 39%. Of the 13 patients with SRSE as a result of anoxic brain injury, SRSE was controlled in 5 (56%). The primary determinant of mortality was family withdrawing care related to the presence of severe medical/neurological diseases.

Original language	English (US)
Pages (from-to)	264-266
Number of pages	3
Journal	Epilepsy and Behavior
Volume	52
DOIs	https://doi.org/10.1016/j.yebeh.2015.07.040
State	Published - Nov 1 2015

Keywords

Anesthetic agents
Ketamine
Mortality
Propofol
Seizure control
Super-refractory status epilepticus
Treatment

ASJC Scopus subject areas

Neurology
Clinical Neurology
Behavioral Neuroscience

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title = "Propofol-ketamine combination therapy for effective control of super-refractory status epilepticus",

abstract = "Retrospective analysis was conducted of patients with SRSE who were treated simultaneously with propofol and ketamine. Sixty-seven patients were identified from 2012 to 2015, and outcomes documented were resolution and mortality. The duration of combined ketamine and propofol use ranged from 1 to 28 days (mean - 3.6 days). Infusion rates ranged up to 145 and 175 mcg/kg/min. Vasopressors were used in 53 patients (79%), and were given within the first 5 days of the ICU admission in 48 (91%) patients. The overall SRSE resolution rate was 91%, and the overall mortality including patients with anoxic brain injury was 39%. Of the 13 patients with SRSE as a result of anoxic brain injury, SRSE was controlled in 5 (56%). The primary determinant of mortality was family withdrawing care related to the presence of severe medical/neurological diseases.",

keywords = "Anesthetic agents, Ketamine, Mortality, Propofol, Seizure control, Super-refractory status epilepticus, Treatment",

author = "Vivek Sabharwal and Eugene Ramsay and Raisa Martinez and Rachel Shumate and Fawad Khan and Hina Dave and Ifeanyi Iwuchukwu and Harold McGrade",

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AU - Sabharwal, Vivek

AU - Ramsay, Eugene

AU - Martinez, Raisa

AU - Shumate, Rachel

AU - Khan, Fawad

AU - Dave, Hina

AU - Iwuchukwu, Ifeanyi

AU - McGrade, Harold

PY - 2015/11/1

Y1 - 2015/11/1

N2 - Retrospective analysis was conducted of patients with SRSE who were treated simultaneously with propofol and ketamine. Sixty-seven patients were identified from 2012 to 2015, and outcomes documented were resolution and mortality. The duration of combined ketamine and propofol use ranged from 1 to 28 days (mean - 3.6 days). Infusion rates ranged up to 145 and 175 mcg/kg/min. Vasopressors were used in 53 patients (79%), and were given within the first 5 days of the ICU admission in 48 (91%) patients. The overall SRSE resolution rate was 91%, and the overall mortality including patients with anoxic brain injury was 39%. Of the 13 patients with SRSE as a result of anoxic brain injury, SRSE was controlled in 5 (56%). The primary determinant of mortality was family withdrawing care related to the presence of severe medical/neurological diseases.

AB - Retrospective analysis was conducted of patients with SRSE who were treated simultaneously with propofol and ketamine. Sixty-seven patients were identified from 2012 to 2015, and outcomes documented were resolution and mortality. The duration of combined ketamine and propofol use ranged from 1 to 28 days (mean - 3.6 days). Infusion rates ranged up to 145 and 175 mcg/kg/min. Vasopressors were used in 53 patients (79%), and were given within the first 5 days of the ICU admission in 48 (91%) patients. The overall SRSE resolution rate was 91%, and the overall mortality including patients with anoxic brain injury was 39%. Of the 13 patients with SRSE as a result of anoxic brain injury, SRSE was controlled in 5 (56%). The primary determinant of mortality was family withdrawing care related to the presence of severe medical/neurological diseases.

KW - Anesthetic agents

KW - Ketamine

KW - Mortality

KW - Propofol

KW - Seizure control

KW - Super-refractory status epilepticus

KW - Treatment

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JO - Epilepsy and Behavior

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ER -

Propofol-ketamine combination therapy for effective control of super-refractory status epilepticus

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

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