Fosphenytoin vs. continuous midazolam for pediatric febrile status epilepticus

Nishiyama, Masahiro; Nagase, Hiroaki; Tomioka, Kazumi; Tanaka, Tsukasa; Yamaguchi, Hiroshi; Ishida, Yusuke; Toyoshima, Daisaku; Fujita, Kyoko; Maruyama, Azusa; Kurosawa, Hiroshi; Uetani, Yoshiyuki; Nozu, Kandai; Taniguchi‐Ikeda, Mariko; Morioka, Ichiro; Takada, Satoshi; Iijima, Kazumoto

doi:10.1016/j.braindev.2018.08.001

Cited by 6 publications

(2 citation statements)

References 23 publications

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“…The efficacy of second-line drugs such as fPHT, valproate, and levetiracetam has been reported to be similar in patients with benzodiazepine resistant SE [ 17 ]. Moreover, we have previously reported that there is no difference in the efficacy of fPHT and MDL ci in pediatric patients with benzodiazepine resistant SE [ 18 ]. Previous studies showed that the efficacy of several second-line agents was similar in patients with benzodiazepine resistant SE, including febrile SE.…”

Section: Discussionmentioning

confidence: 99%

Prognostic effects of treatment protocols for febrile convulsive status epilepticus in children

et al. 2022

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Background Febrile status epilepticus is the most common form of status epilepticus in children. No previous reports compare the effectiveness of treatment strategies using fosphenytoin (fPHT) or phenobarbital (PB) and those using anesthetics as second-line anti-seizure medication for benzodiazepine-resistant convulsive status epilepticus (CSE). We aimed to examine the outcomes of various treatment strategies for febrile convulsive status epilepticus (FCSE) in a real-world setting while comparing the effects of different treatment protocols and their presence or absence. Methods This was a single-center historical cohort study that was divided into three periods. Patients who presented with febrile convulsive status epilepticus for ≥60 min even after the administration of at least one anticonvulsant were included. During period I (October 2002–December 2006), treatment was performed at the discretion of the attending physician, without a protocol. During period II (January 2007–February 2013), barbiturate coma therapy (BCT) was indicated for FCSE resistant to benzodiazepines. During period III (March 2013–April 2016), BCT was indicated for FCSE resistant to fPHT or PB. Results The rate of electroencephalogram monitoring was lower in period I than period II+III (11.5% vs. 85.7%, p<0.01). Midazolam was administered by continuous infusion more often in period I than period II+III (84.6% vs. 25.0%, p<0.01), whereas fPHT was administered less often in period I than period II+III (0% vs. 27.4%, p<0.01). The rate of poor outcome, which was determined using the Pediatric Cerebral Performance Category scale, was higher in period I than period II+III (23.1% vs. 7.1%, p=0.03). The rate of poor outcome did not differ between periods II and III (4.2% vs. 11.1%, p=0.40). Conclusions While the presence of a treatment protocol for FCSE in children may improve outcomes, a treatment protocol using fPHT or PB may not be associated with better outcomes.

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Section: Discussionmentioning

confidence: 99%

Prognostic effects of treatment protocols for febrile convulsive status epilepticus in children

et al. 2022

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“…However, seizure control, seizure recurrence, seizure-free duration and intensive care unit and hospital stay were similar in both the groups [8]. In a pediatric study [9] comparing intravenous fPHT with midazolam infusion as a second line agent in febrile status, efficacy of both was found to be similar and the latter was found to be relatively safe. The proportion of patients requiring barbiturate coma, mechanical ventilation and inotropic support and having incomplete recovery from consciousness was also not significantly different between the groups [9].…”

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Fosphenytoin in Status Epilepticus: The Ice Needs to be Broken

Anand

Chakrabarty

2020

Indian Pediatr

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Lebensrettende Maßnahmen bei Kindern (Paediatric Life Support, PLS)

Voorde

Turner

Djakow

et al. 2021

Notfall Rettungsmed

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Die Leitlinien des European Resuscitation Council (ERC) zu den lebensrettenden Maßnahmen bei Kindern (Paediatric Life Support, PLS) basieren auf dem 2020 verfassten „International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations“ der ILCOR (International Liaison Committee on Resuscitation). Dieses Kapitel beinhaltet Leitlinien zur Behandlung kritisch kranker oder verletzter Säuglinge, von Kindern und Jugendlichen vor, während und nach einem Atem-Kreislauf-Stillstand.

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Fosphenytoin vs. continuous midazolam for pediatric febrile status epilepticus

Abstract: Our results suggest that 1) the efficacy of fPHT and cMDL is similar, although cMDL may prevent the need for BCT compared with fPHT, and 2) fPHT is relatively safe as a second-line treatment for pediatric SE in patients who do not require BCT.

Cited by 6 publications

References 23 publications

Prognostic effects of treatment protocols for febrile convulsive status epilepticus in children

Prognostic effects of treatment protocols for febrile convulsive status epilepticus in children

Fosphenytoin in Status Epilepticus: The Ice Needs to be Broken

Lebensrettende Maßnahmen bei Kindern (Paediatric Life Support, PLS)

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