{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T16:51:54Z","timestamp":1790009514235,"version":"4.0.1"},"reference-count":69,"publisher":"American Medical Association (AMA)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Neurol"],"published-print":{"date-parts":[[2024,5,1]]},"abstract":"<jats:sec id=\"ab-nrv240001-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Multiple continuous intravenous anesthetic drugs (CIVADs) are available for the treatment of refractory status epilepticus (RSE). There is a paucity of data comparing the different types of CIVADs used for RSE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-nrv240001-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To systematically review and compare outcome measures associated with the initial CIVAD choice in RSE in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-nrv240001-6\">\n                    <jats:title>Evidence Review<\/jats:title>\n                    <jats:p>\n                      Data sources included English and non-English articles using Embase, MEDLINE, PubMed, and Web of Science (January 1994-June 2023) as well as manual search. Study selection included peer-reviewed studies of 5 or more patients and at least 1 patient older than 12 years with status epilepticus refractory to a benzodiazepine and at least 1 standard antiseizure medication, treated with continuously infused midazolam, ketamine, propofol, pentobarbital, or thiopental. Independent extraction of articles was performed using prespecified data items. The association between outcome variables and CIVAD was examined with an analysis of variance or \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      test where appropriate. Binary logistic regressions were used to examine the association between outcome variables and CIVAD with etiology, change in mortality over time, electroencephalography (EEG) monitoring (continuous vs intermittent), and treatment goal (seizure vs burst suppression) included as covariates. Risk of bias was addressed by listing the population and type of each study.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-nrv240001-7\">\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      A total of 66 studies with 1637 patients were included. Significant differences among CIVAD groups in short-term failure, hypotension, and CIVAD substitution during treatment were observed. Non\u2013epilepsy-related RSE (vs epilepsy-related RSE) was associated with a higher rate of CIVAD substitution (60 of 120 [50.0%] vs 11 of 43 [25.6%]; odds ratio [OR], 3.11; 95% CI, 1.44-7.11;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.006) and mortality (98 of 227 [43.2%] vs 7 of 63 [11.1%]; OR,\u200917.0; 95% CI, 4.71-109.35;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.001). Seizure suppression was associated with mortality (OR,\u20097.72; 95% CI, 1.77-39.23;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.005), but only a small subgroup was available for analysis (seizure suppression: 17 of 22 [77.3%] from 3 publications vs burst suppression: 25 of 98 [25.5%] from 12 publications). CIVAD choice and EEG type were not predictors of mortality. Earlier publication year was associated with mortality, although the observation was no longer statistically significant after adjusting SEs for clustering.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-nrv240001-8\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>Epilepsy-related RSE was associated with lower mortality compared with other RSE etiologies. A trend of decreasing mortality over time was observed, which may suggest an effect of advances in neurocritical care. The overall data are heterogeneous, which limits definitive conclusions on the choice of optimal initial CIVAD in RSE treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamaneurol.2024.0108","type":"journal-article","created":{"date-parts":[[2024,3,11]],"date-time":"2024-03-11T11:01:34Z","timestamp":1710154894000},"page":"534","source":"Crossref","is-referenced-by-count":28,"title":["Treatment of Refractory Status Epilepticus With Continuous Intravenous Anesthetic Drugs"],"prefix":"10.1001","volume":"81","author":[{"given":"Yu Kan","family":"Au","sequence":"first","affiliation":[{"name":"Department of Neurosciences, Hartford Hospital, University of Connecticut, Hartford, Connecticut"},{"name":"Department of Neurology, University of Connecticut, Farmington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed F.","family":"Kananeh","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hackensack University Medical Center, Hackensack, New Jersey"},{"name":"Department of Neurology, Hackensack Meridian School of Medicine, Hackensack, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Rahangdale","sequence":"additional","affiliation":[{"name":"Neuroscience Institute, Ascension St John Medical Center, Tulsa, Oklahoma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy Eoin","family":"Moore","sequence":"additional","affiliation":[{"name":"Statistical Consulting Services, Center for Open Research Resources & Equipment, University of Connecticut, Storrs"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory A.","family":"Panza","sequence":"additional","affiliation":[{"name":"Department of Research, Hartford HealthCare, Hartford, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Gaspard","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yale University School of Medicine, New Haven, Connecticut"},{"name":"Universit\u00e9 Libre de Bruxelles and Service de Neurologie, H\u00f4pital Universitaire de Bruxelles - H\u00f4pital Erasme, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence J.","family":"Hirsch","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yale University School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andres","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Department of Neurology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed Omar","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Neurology, Thomas Jefferson University Hospital, Philadelphia, 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