Evidence map›Paper›PMID 34566572›Full record

ArticleFrontiers in neuroscience2021

Refractory and Super-Refractory Status Epilepticus in Nerve Agent-Poisoned Rats Following Application of Standard Clinical Treatment Guidelines.

Julia E Morgan, Sara C Wilson, Benjamin J Travis, Kathryn H Bagri, Kathleen T Pagarigan, Hannah M Belski, Cecelia Jackson, Kevin M Bounader, Jessica M Coppola, Eden N Hornung and 2 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Frontiers in neuroscience, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.2field-weighted citation impact, top 22% 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

1 citing paper in PubMed, 11 citations in OpenAlex.

  1. Review
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

12 authors.

Julia E MorganNeuroscience Department, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, United States.
Sara C WilsonNeuroscience Department, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, United States.
Benjamin J TravisNeuroscience Department, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, United States.
Kathryn H BagriNeuroscience Department, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, United States.
Kathleen T PagariganNeuroscience Department, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, United States.
Hannah M BelskiNeuroscience Department, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, United States.
Cecelia JacksonNeuroscience Department, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, United States.
Kevin M BounaderNeuroscience Department, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, United States.
Jessica M CoppolaNeuroscience Department, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, United States.
Eden N HornungNeuroscience Department, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, United States.
James E JohnsonComparative Pathology Department, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, United States.
Hilary S McCarrenNeuroscience Department, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, United States.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Nerve agents (NAs) induce a severe cholinergic crisis that can lead to status epilepticus (SE). Current guidelines for treatment of NA-induced SE only include prehospital benzodiazepines, which may not fully resolve this life-threatening condition. This study examined the efficacy of general clinical protocols for treatment of SE in the specific context of NA poisoning in adult male rats. Treatment with both intramuscular and intravenous benzodiazepines was entirely insufficient to control SE. Second line intervention with valproate (VPA) initially terminated SE in 35% of rats, but seizures always returned. Phenobarbital (PHB) was more effective, with SE terminating in 56% of rats and 19% of rats remaining seizure-free for at least 24 h. The majority of rats demonstrated refractory SE (RSE) and required treatment with a continuous third-line anesthetic. Both ketamine (KET) and propofol (PRO) led to high levels of mortality, and nearly all rats on these therapies had breakthrough seizure activity, demonstrating super-refractory SE (SRSE). For the small subset of rats in which SE was fully resolved, significant improvements over controls were observed in recovery metrics, behavioral assays, and brain pathology. Together these data suggest that NA-induced SE is particularly severe, but aggressive treatment in the intensive care setting can lead to positive functional outcomes for casualties.

Indexed as

nerve agentorganophosphaterefractoryseizuresomanstatus epilepticus

Identifiers

PMID34566572
PMCPMC8462486
OpenAlexW3199037099

What OpenQuestion holds

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LicenceCC BY
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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.