Trial reportIntensive care medicine2006
High-dose midazolam therapy for refractory status epilepticus in children.
Trial report in Intensive care medicine, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 82 citations in OpenAlex.
- Midazolam infusions for therapeutic management of pediatric refractory status epilepticus: a systematic review.Frontiers in pediatrics · 2025Pooled it
- Guidelines for the evaluation and management of status epilepticus.Neurocritical care · 2012Guideline
- Management of Status Epilepticus in Children before and after Implementation of a Treatment Algorithm.The Canadian journal of hospital pharmacy · 2026Article
- Prophylactic effect of compression stockings for elevated D-dimer levels following endoscopic submucosal dissection.DEN open · 2025Article
- A Comparison of Ketamine and Midazolam as First-Line Anesthetic Infusions for Pediatric Status Epilepticus.Neurocritical care · 2024Article
- Risk Factors for Elevated D-Dimer Levels in Patients with Gastrointestinal Tumors Treated with Endoscopic Submucosal Dissection.Journal of clinical medicine · 2023Article
- Refractory and Super-refractory Status Epilepticus.Indian pediatrics · 2020Review
- Observational
- Recurrent Metabolic Acidosis during High-dose Midazolam Therapy for Refractory Status Epilepticus.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2018Article
- Refractory Status Epilepticus in Children: Intention to Treat With Continuous Infusions of Midazolam and Pentobarbital.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2016Observational
- Management of Status Epilepticus in Children.Journal of clinical medicine · 2016Review
- Seizures in a Pediatric Intensive Care Unit: A Prospective Study.Journal of tropical pediatrics · 2016Article
- Super-Refractory Status Epilepticus.Current neurology and neuroscience reports · 2015Review
- Complications during the management of pediatric refractory status epilepticus with benzodiazepine and pentobarbital infusions.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2015Article
- Refractory Convulsive Status Epilepticus in Children: Etiology, Associated Risk Factors and Outcome.Iranian journal of child neurology · 2015Article
- Status epilepticus and refractory status epilepticus management.Seminars in pediatric neurology · 2014Review
- High-dose midazolam infusion for refractory status epilepticus.Neurology · 2014Article
- Risk factors associated with death in in-hospital pediatric convulsive status epilepticus.PloS one · 2012Article
- Status epilepticus.Indian journal of pediatrics · 2011Article
- Convulsive and nonconvulsive status epilepticus in children.Current treatment options in neurology · 2009Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess the efficacy of high-dose midazolam in the treatment of refractory status epilepticus in children.
settingPaediatric intensive care unit (PICU).
designAudit of clinical experience. SUBJECTS: Seventeen consecutive patients treated for episodes of refractory status epilepticus.
interventionsAlgorithm-driven administration of intravenous midazolam to control RSE. Regular, mandatory, patient evaluation to avoid delay in the appropriate escalation of therapy. Our target was the abolition of clinical seizures within 30 min of initiating treatment and early confirmation of cessation of all seizure activity using EEG. The algorithm had failed if clinical seizures persisted beyond 30 min despite the administration of midazolam at 24 microg/kg/min or if administration of a further acute anti-epileptic drug was required to achieve seizure control. MEASUREMENTS: The midazolam infusion rate, cumulative midazolam dose and duration of midazolam therapy at time of clinical seizure control were recorded. Haemodynamic parameters were recorded continuously. Episodes of algorithm failure, breakthrough seizures and seizure relapses were identified. Patient outcome was measured in terms of survival to PICU discharge.
resultsIn 13 patients (76%) midazolam achieved clinical seizure control within 30 min of treatment initiation. Midazolam was eventually successful in treating 15 seizure episodes (88%). Breakthrough seizures occurred in 8 patients (47%). Relapse after discontinuation of therapy occurred in 1 patient (6%). No significant adverse effects attributable to the use of midazolam occurred. There were 3 deaths (18%) related to underlying CNS pathology.
conclusionsMidazolam can offer control of refractory status epilepticus without significant morbidity.
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