Levetiracetam use in critically ill patients.

Abstract:

INTRODUCTION:Levetiracetam (LEV) is used in the setting of acute brain injury for seizure treatment or prophylaxis but its safety and efficacy in this setting is unknown. METHOD:We retrospectively analyzed the patterns of use and safety/efficacy of LEV in 379 patients treated in the neuroscience intensive care unit (NSICU). We extracted from the charts clinical data including diagnosis, AED therapy before and during stay in the NSICU, complications of treatment, length of stay, and clinical outcomes (improvement, Glasgow Coma Scale, and death). We analyzed the data using binary and ordered (multi-category) logistic regression. RESULTS:Overall, our findings are that phenytoin used prior to the NSICU admission was frequently replaced with LEV monotherapy (P < 0.001). Patients treated with LEV monotherapy when compared to other AEDs had lower complication rates and shorter NSICU stays. Older patients and patients with brain tumors or strokes were preferentially treated with LEV for prevention and/or management of seizures (all P < or = 0.014). DISCUSSION:The results of this study suggest that LEV is a frequently used AED in the setting of acute brain injury and that it may be a desirable alternative to phenytoin. Prospective studies evaluating the long-term safety, efficacy and outcomes of LEV in this setting are indicated.

journal_name

Neurocrit Care

journal_title

Neurocritical care

authors

Szaflarski JP,Meckler JM,Szaflarski M,Shutter LA,Privitera MD,Yates SL

doi

10.1007/s12028-007-0042-8

subject

Has Abstract

pub_date

2007-01-01 00:00:00

pages

140-7

issue

2

eissn

1541-6933

issn

1556-0961

journal_volume

7

pub_type

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