UMEM Educational Pearls

Title: Refractory Status Epilepticus

Category: Critical Care

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

Posted: 8/30/2016 by Mike Winters, MBA, 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.

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