Suryawanshi Vaibhav Rajendra, Srivastava Kavita, Panda Bijoy Kumar
Department of Clinical Pharmacy, Poona College of Pharmacy, Bharati Vidyapeeth (Deemed to be University), Pune, Maharashtra, 411038, India.
Pediatric Neurology Unit, Department of Pediatrics, Bharati Vidyapeeth (Deemed to be University) Medical College and Hospital, Dhankawadi Campus, Pune, Maharashtra, India.
Indian J Pediatr. 2022 May;89(5):503-506. doi: 10.1007/s12098-021-04017-8. Epub 2022 Jan 22.
Data regarding time elapsed from the onset of pediatric convulsive status epilepticus (CSE) to antiepileptic (AED) administration remains scarce after the adoption of standard treatment-guidelines in Indian healthcare settings. A prospective observational analysis was performed on 52 children presenting to an urban, academic tertiary care teaching hospital diagnosed with CSE and evolving to refractory CSE (RCSE). Time frames of AED administration were compared to the adopted 'Status Epilepticus Management Protocol'. Fifty-two patients [36 (69.2%) male] were enrolled, with a median age of 4.1 y. After CSE onset, the median (p25-p75) time until the administration of the first-line, second-line, and third-line therapy phases of AED doses were 30 (25-37) min, 68 (48-79) min, and 105 (100-135) min, respectively. The second dose of non-BZD AED was administered at a median (p25-p75) of 90 (71-95) min. Twenty-six (50%) patients received at least one continuous infusion. The time elapsed from CSE onset to AED administration and escalation from one class to another was delayed.
在印度医疗环境中采用标准治疗指南后,关于小儿惊厥性癫痫持续状态(CSE)发作至抗癫痫药物(AED)给药的时间数据仍然匮乏。对一家城市学术三级护理教学医院收治的52例诊断为CSE并进展为难治性CSE(RCSE)的儿童进行了前瞻性观察分析。将AED给药的时间框架与采用的“癫痫持续状态管理方案”进行了比较。纳入了52例患者[36例(69.2%)为男性],中位年龄为4.1岁。CSE发作后,一线、二线和三线治疗阶段AED剂量给药的中位(第25-75百分位数)时间分别为30(25-37)分钟、68(48-79)分钟和105(100-135)分钟。非苯二氮䓬类AED的第二剂给药中位时间(第25-75百分位数)为90(71-95)分钟。26例(50%)患者接受了至少一次持续输注。从CSE发作到AED给药以及从一类药物升级到另一类药物的时间有所延迟。