title: Continuous infusion pentobarbital for refractory status epilepticus in children.
abstract: 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.
authors.affiliation: Department of Pharmacy, Children's Hospital Colorado, Aurora, CO 80045, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Barberio
authors.forename: Pamela D
authors.initials: PD
authors.lastname: Reiter
authors.forename: Jon
authors.initials: J
authors.lastname: Kaufman
authors.forename: Kelly
authors.initials: K
authors.lastname: Knupp
authors.forename: Emily L
authors.initials: EL
authors.lastname: Dobyns
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004334:Drug Administration Schedule; D004569:Electroencephalography; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007223:Infant; D007231:Infant, Newborn; D007262:Infusions, Intravenous / Q000379:methods; D008297:Male; D009460:Neurologic Examination; D010424:Pentobarbital / Q000008:administration & dosage*; D012189:Retrospective Studies; D013226:Status Epilepticus / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D006993:Hypnotics and Sedatives; D010424:Pentobarbital