Henning Robert Stetefeld, Alexander Schaal, Franziska Scheibe, Julia Friederike Nichtweiß, Felix Lehmann, Marcus Müller, Stefan Toni Gerner, Hagen Bernhard Huttner, Sebastian Luger, Hannah Fuhrer, Julian Bösel, Silvia Schönenberger, Konstantinos Dimitriadis, Bernhard Neumann, Kornelius Fuchs, Gereon R. Fink, Michael Peter Malter
- Background: We aimed to determine the association between seizure termination and side effects of isoflurane for the treatment of refractory status epilepticus (RSE) and super-refractory status epilepticus (SRSE) in neurointensive care units (neuro-ICUs).
Methods: This was a multicenter retrospective study of patients with RSE/SRSE treated with isoflurane for status epilepticus termination admitted to the neuro-ICUs of nine German university centers during 2011–2018.
Results: We identified 45 patients who received isoflurane for the treatment of RSE/SRSE. During isoflurane treatment, electroencephalograms showed no epileptiform discharges in 33 of 41 (80%) patients, and burst suppression pattern was achieved in 29 of 41 patients (71%). RSE/SRSE was finally terminated after treatment with isoflurane in 23 of 45 patients (51%) for the entire group and in 13 of 45 patients (29%) without additional therapy. Lengths of stay in the hospital and in the neuro-ICU were significantly extended in cases of ongoing status epilepticus under isoflurane treatment (p = 0.01 for length of stay in the hospital, p = 0.049 for length in the neuro-ICU). During isoflurane treatment, side effects were reported in 40 of 45 patients (89%) and mainly included hypotension (n = 40, 89%) and/or infection (n = 20, 44%). Whether side effects occurred did not affect the outcome at discharge. Of 22 patients with follow-up magnetic resonance imaging, 2 patients (9%) showed progressive magnetic resonance imaging alterations that were considered to be potentially associated with RSE/SRSE itself or with isoflurane therapy.
Conclusions; Isoflurane was associated with a good effect in stopping RSE/SRSE. Nevertheless, establishing remission remained difficult. Side effects were common but without effect on the outcome at discharge.
MetadatenAuthor: | Henning Robert StetefeldORCiDGND, Alexander Schaal, Franziska Scheibe, Julia Friederike NichtweißORCiDGND, Felix LehmannORCiD, Marcus Müller, Stefan Toni GernerORCiDGND, Hagen Bernhard HuttnerGND, Sebastian LugerORCiDGND, Hannah FuhrerGND, Julian BöselGND, Silvia SchönenbergerORCiDGND, Konstantinos DimitriadisGND, Bernhard NeumannORCiDGND, Kornelius Fuchs, Gereon R. FinkORCiDGND, Michael Peter MalterORCiDGND |
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URN: | urn:nbn:de:hebis:30:3-628115 |
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DOI: | https://doi.org/10.1007/s12028-021-01250-z |
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ISSN: | 1556-0961 |
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Parent Title (English): | Neurocritical care |
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Publisher: | Springer |
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Place of publication: | New York, NY |
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Document Type: | Article |
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Language: | English |
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Date of Publication (online): | 2021/07/20 |
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Date of first Publication: | 2021/07/20 |
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Publishing Institution: | Universitätsbibliothek Johann Christian Senckenberg |
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Contributing Corporation: | IGNITE Study Group, with support from the German Neurocritical Care Society (DGNI) |
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Release Date: | 2022/07/11 |
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Tag: | Epilepsy; Isoflurane; Status epilepticus |
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Volume: | 35.2021 |
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Issue: | 3 |
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Page Number: | 9 |
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First Page: | 631 |
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Last Page: | 639 |
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Note: | Open Access funding enabled and organized by Projekt DEAL. |
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HeBIS-PPN: | 502749245 |
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Institutes: | Medizin |
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Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
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Sammlungen: | Universitätspublikationen |
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Licence (German): | Creative Commons - Namensnennung 4.0 |
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