Benzodiazepine overtreatment in status epilepticus is related to higher need of intubation and longer hospitalization.

Details

Serval ID
serval:BIB_D98A05D25553
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Benzodiazepine overtreatment in status epilepticus is related to higher need of intubation and longer hospitalization.
Journal
Epilepsia
Author(s)
Spatola M., Alvarez V., Rossetti A.O.
ISSN
1528-1167 (Electronic)
ISSN-L
0013-9580
Publication state
Published
Issued date
2013
Volume
54
Number
8
Pages
e99-e102
Language
english
Notes
Publication types: Journal Article; PDF : brief communication
Abstract
Benzodiazepine (BDZ), a widely recognized first-line status epilepticus (SE) treatment, may lead to respiratory depression. This cohort study investigates the effect of BDZ doses in SE patients in terms of morbidity and mortality. It considers incident SE episodes from a prospective registry (2009-2012), comparing patients receiving standard BDZ dose to those receiving exceeding doses (>30% above recommended dose), in terms of likelihood to receive intubation, morbidity, and mortality. Duration of hospitalization was assessed for subjects needing intubation for airways protection (not for refractory SE treatment) versus matched subjects not admitted to the intensive care unit (ICU). We identified 29 subjects receiving "excessive" and 173 "standard" BDZ dose; 45% of the overtreated patients were intubated for airways protection, but only 8% in the standard-dose group (p < 0.001). However, both groups presented similar clinical outcomes: 50% returned to baseline, 40% acquired a new handicap, and 10% died. Orotracheal intubation due to airways protection was associated with significantly longer hospitalization (mean 2 weeks vs. 1 week, p = 0.008). In conclusion, although administration of excessive BDZ doses in SE treatment does not seem to influence outcome, it is related to higher respiratory depression risk and longer hospitalization, potentially exposing patients to additional complications and costs.
Pubmed
Web of science
Open Access
Yes
Create date
08/09/2013 10:19
Last modification date
20/08/2019 16:58
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