UMEM Educational Pearls

Category: Critical Care

Title: Refractory Status Epilepticus

Keywords: refractory status epilepticus, ketamine, propofol, siezure, midazolam (PubMed Search)

Posted: 8/30/2016 by Mike Winters, MD
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Ketamine for RSE?

  • Up to 43% of patients with status epilepticus may progress to refractory status epilepticus (RSE).
  • Propofol, midazolam, and barbituates are often recommended for patients with RSE.
  • Importantly, all of these medications may be limited by hypotension and respiratory depression.
  • Ketamine is emerging as adjuvant therapy for patients with RSE.
  • The loading dose of ketamine ranges from 0.5 to 3 mg/kg, followed by a maintenance infusion of 0.3 to 4 mg/kg/h.

References

Legriel S, et al. What's new in refractory status epilepticus? Intensive Care Med 2016. [Epub ahead of print]