Evidence map›Paper›PMID 29582225›Full record

ArticleNeurocritical care2018

Outcomes in Children Treated with Pentobarbital Infusion for Refractory and Super-Refractory Status Epilepticus.

Jennifer Erklauer, Jeanine Graf, Mona McPherson, Anne Anderson, Angus Wilfong, Charles G Minard, Laura Loftis

Abstract read
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In one paragraph

Article in Neurocritical care, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 2 pooled it
0.5field-weighted citation impact, top 35% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 2 syntheses or guidelines pooled it, 14 citations in OpenAlex.

  1. Pooled it
  2. Guideline
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Jennifer ErklauerDepartment of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, 6701 Fannin Street, Suite 1250, Houston, TX, 77030, USA. jclee@bcm.edu.ORCID http://orcid.org/0000-0002-2960-7645
Jeanine GrafDepartment of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, 6621 Fannin Street, WT6-006, Houston, TX, 77030, USA.
Mona McPhersonDepartment of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, 6621 Fannin Street, WT6-006, Houston, TX, 77030, USA.
Anne AndersonDepartment of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, 6701 Fannin Street, Suite 1250, Houston, TX, 77030, USA.
Angus WilfongDivision of Pediatric Neurology, Barrow Neurologic Institute, Phoenix, AZ, USA.
Charles G MinardDan L. Duncan Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, TX, USA.
Laura LoftisDepartment of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, 6621 Fannin Street, WT6-006, Houston, TX, 77030, USA.
Baylor College of Medicine · USBarrow Neurological Institute · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFunctional neurologic outcome for children with refractory and super-refractory status epilepticus has not been well defined.

methodsRetrospective chart review including children age 0-17 years who received pentobarbital infusion from 2003 to 2016 for status epilepticus. Outcomes were defined in terms of mortality, need for new medical technology assistance at hospital discharge and functional neurologic outcome determined by pediatric cerebral performance category score (PCPC). Potential patient characteristics associated with functional neurologic outcome including age, sex, ethnicity, etiology of the status epilepticus, and duration of pentobarbital infusion were evaluated.

resultsForty children met inclusion criteria. In-hospital mortality was 30% (12/40). Of survivors, 21% (6/28) returned to baseline PCPC while half (14/28) declined in function ≥ 2 PCPC categories at hospital discharge. 25% (7/28) of survivors required tracheostomy and 27% (7/26) required new gastrostomy. Seizures persisted at discharge for most patients with new onset status epilepticus while the majority of patients with known epilepsy returned to baseline seizure frequency. Etiology (p = 0.015), PCPC at admission (p = 0.0006), new tracheostomy (p = 0.012), and new gastrostomy tube (p = 0.012) were associated with increase in PCPC score ≥ 2 categories in univariable analysis. Duration of pentobarbital infusion (p = 0.005) and length of hospital stay (p = 0.056) were longer in patients who demonstrated significant decline in neurologic function. None of these variables maintained statistical significance when multiple logistic regression model adjusting for PCPC score at admission was applied. At long-term follow-up, 36% (8/22) of children demonstrated improvement in PCPC compared to discharge and 23% (5/22) showed deterioration including three additional deaths.

conclusionsMortality in this population was high. The majority of children experienced some degree of disability at discharge. Despite prolonged pentobarbital infusion, there were cases of survival with good neurologic outcome.

Indexed as

Outcome Assessment, Health CareAdolescentChildChild, PreschoolDrug Resistant EpilepsyFemaleFollow-Up StudiesGABA ModulatorsHospital MortalityHumansInfantIntensive Care Units, PediatricMalePentobarbitalRetrospective StudiesStatus EpilepticusGABA ModulatorsPentobarbitalFunctional neurologic outcomePediatric cerebral performance categoryPediatric intensive care unitPentobarbital infusionRefractory status epilepticusSuper-refractory status epilepticus

Identifiers

PMID29582225
OpenAlexW2793011098

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.