{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T12:53:27Z","timestamp":1783947207009,"version":"3.55.0"},"reference-count":51,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,6,17]],"date-time":"2024-06-17T00:00:00Z","timestamp":1718582400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Status epilepticus (SE) is a common neurological medical emergency in the pediatric population, with 10%\u201340% of cases progressing to refractory SE (RSE), requiring treatment with anesthetic infusions. We present a systematic review and meta\u2010analysis of the use of ketamine for the treatment of pediatric SE and its potential advantages over other anesthetic infusions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This review follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses) statement. Electronic databases, including PubMed, Cochrane Library, Ovid, Embase, and Google Scholar, were searched with the keywords \u201cpediatrics,\u201d \u201cstatus epilepticus,\u201d and \u201cketamine treatment.\u201d Randomized trials, prospective and retrospective cohort studies, and case reports were considered for inclusion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighteen publications met the initial inclusion criteria. The 18 publications comprise 11 case reports, one nonconclusive clinical trial, two case series, and four retrospective cohorts. After excluding the case reports because of reporting bias, only the six case series and cohorts were included in the final analysis. There were 172 patients in the six included studies. The weighted age was 9.93 (SD\u2009=\u200910.29) years. The weighted maximum dose was 7.44 (SD\u2009=\u20099.39) mg\/kg\/h. SE cessation was attained in 51% (95% confidence interval\u2009=\u200943\u201359) of cases with the addition of ketamine. The heterogeneity was <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090%, <jats:italic>t<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090, \u03c7<jats:sup>2<\/jats:sup> (5)\u2009=\u20093.39 (<jats:italic>p<\/jats:italic>\u2009=\u2009.64).<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Pediatric RSE is difficult to treat, resulting in increased morbidity and mortality. Without strong recommendations and evidence regarding preferred agents, this review provides evidence that ketamine may be considered in managing SE in the pediatric population.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.18035","type":"journal-article","created":{"date-parts":[[2024,6,17]],"date-time":"2024-06-17T07:35:38Z","timestamp":1718609738000},"page":"2200-2212","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["A systematic review and meta\u2010analysis of ketamine in pediatric status epilepticus"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-3004-8486","authenticated-orcid":false,"given":"Nicolas","family":"Chiriboga","sequence":"first","affiliation":[{"name":"Pediatric Intensive Care Unit Le Bonheur Children's Hospital  Memphis Tennessee USA"},{"name":"Department of Pediatrics University of Tennessee Health Science Center  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Spentzas","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit Le Bonheur Children's Hospital  Memphis Tennessee USA"},{"name":"Department of Pediatrics University of Tennessee Health Science Center  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3671-1376","authenticated-orcid":false,"given":"Renad","family":"Abu\u2010Sawwa","sequence":"additional","affiliation":[{"name":"Department of Anatomy and Cell Biology Rush Medical College  Chicago Illinois USA"},{"name":"Department of Pediatric Neurology Rush University Children's Hospital  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,17]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2018.05.012"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm5050049"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1157.1999.tb00873.x"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1528-1157.2001.21301.x"},{"key":"e_1_2_12_6_1","first-page":"187","volume-title":"Antiepileptic drugs","author":"Levy Rene H","year":"2002"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-008-9168-6"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.51.6.1765"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.3109\/03009734.2015.1060281"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.14676"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/0883073817698629"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n160"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0121388"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v036.i03"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/08830738050200030301"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2008.08.005"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/WNF.0b013e3181d1e3cd"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.braindev.2016.03.010"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2014.03.006"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-3402005"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2021.10.052"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.5863\/1551-6776-28.2.161"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1080\/10903127.2023.2221967"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2023.1189478"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1059-1311(03)00028-1"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000200889"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.12247"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2015.06.019"},{"issue":"4","key":"e_1_2_12_29_1","first-page":"295","article-title":"Effectiveness of ketamine in the treatment of refractory and super\u2010refractory status epilepticus in children","volume":"58","author":"Wu J","year":"2020","journal-title":"Zhonghua Er Ke Za Zhi Chin J Pediatr"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e318278b685"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/epi4.12627"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/cns.12099"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/831260"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17550"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.1547-16.2016"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/cns.12104"},{"issue":"1","key":"e_1_2_12_37_1","first-page":"47","article-title":"The anti\u2010inflammatory effects of ketamine: state of the art","volume":"62","author":"Loix S","year":"2011","journal-title":"Acta Anaesthesiol Belg"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2014.01.041"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12035-015-9476-8"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2021.672526"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-16183-x"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1038\/mp.2015.211"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0074-7742(08)60561-9"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2016.03.005"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2008.10.003"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm5040047"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1177\/088307388800300303"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2008.01.001"},{"key":"e_1_2_12_49_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40263-018-0569-6"},{"key":"e_1_2_12_50_1","first-page":"1","article-title":"A comparison of ketamine and midazolam as first line anesthetic infusions for pediatric status epilepticus","author":"Jacobwitz M","year":"2023","journal-title":"Neurocrit Care"},{"key":"e_1_2_12_51_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-011384"},{"key":"e_1_2_12_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2008.10.003"}],"container-title":["Epilepsia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/epi.18035","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,9]],"date-time":"2024-08-09T10:50:10Z","timestamp":1723200610000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/epi.18035"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,17]]},"references-count":51,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,8]]}},"alternative-id":["10.1111\/epi.18035"],"URL":"https:\/\/doi.org\/10.1111\/epi.18035","archive":["Portico"],"relation":{},"ISSN":["0013-9580","1528-1167"],"issn-type":[{"value":"0013-9580","type":"print"},{"value":"1528-1167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,17]]},"assertion":[{"value":"2023-12-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}