Universität zu Köln

Stetefeld, Henning R., Schaal, Alexander, Scheibe, Franziska, Nichtweiss, Julia, Lehmann, Felix, Mueller, Marcus, Gerner, Stefan T. ORCID: 0000-0001-6020-8290, Huttner, Hagen B., Luger, Sebastian, Fuhrer, Hannah, Boesel, Julian, Schoenenberger, Silvia, Dimitriadis, Konstantinos, Neumann, Bernhard, Fuchs, Kornelius, Fink, Gereon R. ORCID: 0000-0002-8230-1856 and Malter, Michael P. (2021). Isoflurane in (Super-) Refractory Status Epilepticus: A Multicenter Evaluation. Neurocrit. Care, 35 (3). S. 631 - 640. TOTOWA: HUMANA PRESS INC. ISSN 1556-0961

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Abstract

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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Stetefeld, Henning R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schaal, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Scheibe, Franziska UNSPECIFIED UNSPECIFIED UNSPECIFIED Nichtweiss, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Lehmann, Felix UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Marcus UNSPECIFIED UNSPECIFIED UNSPECIFIED Gerner, Stefan T. UNSPECIFIED orcid.org/0000-0001-6020-8290 UNSPECIFIED Huttner, Hagen B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Luger, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Fuhrer, Hannah UNSPECIFIED UNSPECIFIED UNSPECIFIED Boesel, Julian UNSPECIFIED UNSPECIFIED UNSPECIFIED Schoenenberger, Silvia UNSPECIFIED UNSPECIFIED UNSPECIFIED Dimitriadis, Konstantinos UNSPECIFIED UNSPECIFIED UNSPECIFIED Neumann, Bernhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Fuchs, Kornelius UNSPECIFIED UNSPECIFIED UNSPECIFIED Fink, Gereon R. UNSPECIFIED orcid.org/0000-0002-8230-1856 UNSPECIFIED Malter, Michael P. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-602052
DOI:	10.1007/s12028-021-01250-z
Journal or Publication Title:	Neurocrit. Care
Volume:	35
Number:	3
Page Range:	S. 631 - 640
Date:	2021
Publisher:	HUMANA PRESS INC
Place of Publication:	TOTOWA
ISSN:	1556-0961
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CONVULSIVE STATUS EPILEPTICUS; MORTALITY; PREDICTORS; THERAPIES; SEDATION; SCORE Multiple languages Critical Care Medicine; Clinical Neurology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/60205