Your browser doesn't support javascript.
loading
Comparison of etomidate and sodium thiopental for induction during rapid sequence intubation in convulsive status epilepticus: A retrospective single-center study.
Perier, François; Chateauneuf, Anne-Laure; Jacq, Gwenaëlle; Holleville, Mathilde; Schnell, David; Merceron, Sybille; Cavelot, Sébastien; Richard, Olivier; Legriel, Stéphane.
Afiliação
  • Perier F; Intensive Care Unit, Centre Hospitalier de Versailles - Site André Mignot, 177 rue de Versailles, 78150 Le Chesnay Cedex, France.
  • Chateauneuf AL; Intensive Care Unit, Centre Hospitalier de Versailles - Site André Mignot, 177 rue de Versailles, 78150 Le Chesnay Cedex, France.
  • Jacq G; Intensive Care Unit, Centre Hospitalier de Versailles - Site André Mignot, 177 rue de Versailles, 78150 Le Chesnay Cedex, France.
  • Holleville M; Intensive Care Unit, Centre Hospitalier de Versailles - Site André Mignot, 177 rue de Versailles, 78150 Le Chesnay Cedex, France.
  • Schnell D; Intensive Care Unit, Centre Hospitalier d'Angoulême, Rond point de Girac, 16959 Angoulême, France.
  • Merceron S; Intensive Care Unit, Centre Hospitalier de Versailles - Site André Mignot, 177 rue de Versailles, 78150 Le Chesnay Cedex, France.
  • Cavelot S; Intensive Care Unit, Centre Hospitalier de Versailles - Site André Mignot, 177 rue de Versailles, 78150 Le Chesnay Cedex, France.
  • Richard O; SAMU 78, Centre Hospitalier de Versailles - Site André Mignot, 177 rue de Versailles, 78150 Le Chesnay Cedex, France.
  • Legriel S; Intensive Care Unit, Centre Hospitalier de Versailles - Site André Mignot, 177 rue de Versailles, 78150 Le Chesnay Cedex, France; Paris Descartes University, Sorbonne Paris Cité-Medical School, Paris, France; INSERM U970, Paris Cardiovascular Research Center, Paris, France. Electronic address: slegr
Seizure ; 61: 170-176, 2018 Oct.
Article em En | MEDLINE | ID: mdl-30176574
ABSTRACT

PURPOSE:

Few outcome data are available about morbidity associated with endotracheal intubation modalities in critically ill patients with convulsive status epilepticus. We compared etomidate versus sodium thiopental for emergency rapid sequence intubation in patients with out-of-hospital convulsive status epilepticus.

METHODS:

Patients admitted to our intensive care unit in 2006-2015 were studied retrospectively. The main outcome measure was seizure and/or status epilepticus recurrence within 12 h after rapid sequence intubation.

RESULTS:

We included 97 patients (60% male; median age, 59 years [IQR, 48-70]). Median time from seizure onset to first antiepileptic drug was 60 min [IQR, 35-90]. Reasons for intubation were coma in 95 (98%), acute respiratory distress in 18 (19%), refractory convulsive status epilepticus in 9 (9%), and shock in 6 (6%) patients; 50 (52%) patients had more than one reason. The hypnotic drugs used were etomidate in 54 (56%) and sodium thiopental in 43 (44%) patients. Seizure and/or status epilepticus recurred in 13 (56%) patients in the etomidate group and 11 patients (44%) in the sodium thiopental group (adjusted common odds ratio [aOR], 0.98; 95%CI, 0.36-2.63; P = 0.97). The two groups were not significantly different for proportions of patients with hemodynamic instability after intubation (aOR, 0.60; 95%CI, 0.23-1.58; P = 0.30) or with difficult endotracheal intubation (OR, 1.28; 95% CI 0.23 to 7.21; P=0.77).

CONCLUSIONS:

Our findings argue against a difference in seizure and/or status epilepticus recurrences rates between critically ill patients with convulsive status epilepticus given etomidate vs. sodium thiopental as the induction agent for emergency intubation.
Assuntos
Palavras-chave

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Estado Epiléptico / Tiopental / Etomidato / Hipnóticos e Sedativos / Intubação Tipo de estudo: Etiology_studies / Observational_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2018 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Estado Epiléptico / Tiopental / Etomidato / Hipnóticos e Sedativos / Intubação Tipo de estudo: Etiology_studies / Observational_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2018 Tipo de documento: Article