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.
authors.affiliation: Ochsner Medical Center, New Orleans, LA, USA.
authors.forename: Vivek
authors.initials: V
authors.lastname: Sabharwal
authors.affiliation: Ochsner Medical Center, New Orleans, LA, USA. Electronic address: eramsay@ochsner.org.
authors.forename: Eugene
authors.initials: E
authors.lastname: Ramsay
authors.affiliation: Louisiana State University HSC, New Orleans, LA, USA.
authors.forename: Raisa
authors.initials: R
authors.lastname: Martinez
authors.affiliation: Ochsner Medical Center, New Orleans, LA, USA.
authors.forename: Rachel
authors.initials: R
authors.lastname: Shumate
authors.affiliation: Ochsner Medical Center, New Orleans, LA, USA.
authors.forename: Fawad
authors.initials: F
authors.lastname: Khan
authors.affiliation: Ochsner Medical Center, New Orleans, LA, USA.
authors.forename: Hina
authors.initials: H
authors.lastname: Dave
authors.affiliation: Ochsner Medical Center, New Orleans, LA, USA.
authors.forename: Ifeanyi
authors.initials: I
authors.lastname: Iwuchukwu
authors.affiliation: Ochsner Medical Center, New Orleans, LA, USA.
authors.forename: Harold
authors.initials: H
authors.lastname: McGrade
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000778:Anesthetics, Dissociative / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D003422:Critical Care; D000069279:Drug Resistant Epilepsy / Q000188:drug therapy* / Q000401:mortality; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D002534:Hypoxia, Brain / Q000209:etiology / Q000401:mortality; D007262:Infusions, Intravenous; D007649:Ketamine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015742:Propofol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies; D013226:Status Epilepticus / Q000188:drug therapy* / Q000401:mortality; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000778:Anesthetics, Dissociative; D018686:Anesthetics, Intravenous; D014662:Vasoconstrictor Agents; D007649:Ketamine; D015742:Propofol
keywords: Anesthetic agents; Ketamine; Mortality; Propofol; Seizure control; Super-refractory status epilepticus; Treatment