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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care
Minerva Anestesiologica 2015 June;81(6):645-9
Multimodal neurological approach can lead the treatment in postcardiac arrest persistent refractory status epilepticus
Coppo A. 1, Beretta S. 1, Sulmina E. 2, Greco G. 1, Pesenti A. 1, 2, 3, Avalli L. 1
1 Dipartimento di Emergenza e Urgenza, Ospedale San Gerardo, Monza, Italia;
2 Dipartimento di Scienze della Salute, Università Milano-Bicocca, Monza, Italia;
3 Clinica Neurologica, Ospedale San Gerardo, Monza, Italia
Refractory status epilepticus (RSE) is a common challenge in the setting of post resuscitation care. We describe how multimodal neurological approach can lead treatment and improve the prognosis.
We report on three survivors of cardiac arrest (CA) who had good neurological outcomes after mild hypothermia (TH), despite exhibiting persisting RSE requiring treatment with several antiepileptic (AED) and anesthetic drugs, including barbiturate-induced coma. No evidence-based data exist to guide management of RSE in the setting of anoxic brain injury. Our cases emphasize the need for continuous active treatment led by a multimodal approach in order to improve neurological outcome.