Continuous infusion pentobarbital for refractory status epilepticus in children.

Michael Barberio, Pamela D Reiter, Jon Kaufman, Kelly Knupp, Emily L Dobyns

Department of Pharmacy, Children's Hospital Colorado, Aurora, CO 80045, USA.

Journal of child neurology 2012 Jun

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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.

Citation

Michael Barberio, Pamela D Reiter, Jon Kaufman, Kelly Knupp, Emily L Dobyns. Continuous infusion pentobarbital for refractory status epilepticus in children. Journal of child neurology. 2012 Jun;27(6):721-6