Abstract：
BACKGROUND:Status, refractory status and super refractory status epilepticus are common neurologic emergencies. The objective of this study is to investigate the feasibility, safety and effectiveness of a ketogenic diet (KD) for refractory status epilepticus (RSE) in adults in the intensive care unit (ICU). METHODS:We performed a retrospective, single-center study of patients between ages 18 and 80 years with RSE treated with a KD treatment algorithm from November 2016 through April 2018. The primary outcome measure was urine ketone body production as a biomarker of feasibility. Secondary measures included resolution of RSE and KD-related side effects. RESULTS:There were 11 adults who were diagnosed with RSE that were treated with the KD. The mean age was 48 years, and 45% (n = 5) of the patients were women. The patients were prescribed a median of three anti-seizure medications before initiating the KD. The median duration of RSE before initiation of the KD was 1 day. Treatment delays were the result of Propofol administration. 90.9% (n = 10) of patients achieved ketosis within a median of 1 day. RSE resolved in 72.7% (n = 8) of patients; however, 27.3% (n = 3) developed super-refractory status epilepticus. Side effects included metabolic acidosis, hypoglycemia and hyponatremia. One patient (20%) died. CONCLUSIONS:KD may be feasible, safe and effective for treatment of RSE in the ICU. A randomized controlled trial (RCT) may be indicated to further test the safety and efficacy of KD.
journal_name
Neurocrit Carejournal_title
Neurocritical careauthors
Francis BA,Fillenworth J,Gorelick P,Karanec K,Tanner Adoi
10.1007/s12028-018-0653-2subject
Has Abstractpub_date
2019-06-01 00:00:00pages
652-657issue
3eissn
1541-6933issn
1556-0961pii
10.1007/s12028-018-0653-2journal_volume
30pub_type
杂志文章abstract：INTRODUCTION:Bacterial meningitis is associated with a high mortality and a high incidence of neurological sequelae. Parainfectious vasculitis leading to ischemic brain damage is a known complication of bacterial meningitis but its treatment is uncertain. METHODS AND RESULTS:We report the case of a 53-year-old man wit...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1385/NCC:4:3:237
更新日期：2006-01-01 00:00:00
abstract：BACKGROUND AND PURPOSE:Patients with acute brain injuries require strict physiologic control to minimize morbidity and mortality. This study aimed to assess in-hospital compliance to strict physiologic parameters (BP, HR, ICP, SpO2) in these populations. METHODS:Patients with severe cerebrovascular events were admitte...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-015-0116-y
更新日期：2015-12-01 00:00:00
abstract：:Multi-modal monitoring has become an integral part of neurointensive care. However, our approach is at this time neither standardized nor backed by data from randomized controlled trials. The goal of the second Neurocritical Care Research Conference was to discuss research priorities in multi-modal monitoring, what re...
journal_title：Neurocritical care
pub_type： 杂志文章,评审
doi：10.1007/s12028-015-0134-9
更新日期：2015-06-01 00:00:00
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journal_title：Neurocritical care
pub_type： 杂志文章,评审
doi：10.1007/s12028-009-9242-8
更新日期：2009-12-01 00:00:00
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journal_title：Neurocritical care
pub_type： 杂志文章,meta分析
doi：10.1007/s12028-018-0658-x
更新日期：2019-08-01 00:00:00
abstract：:Neuromuscular disorders increasingly are recognized as a complication in patients in the intensive care unit (ICU) and represent a common cause of prolonged ventilator dependency. The distinct syndromes of critical illness myopathy, prolonged neuromuscular blockade, and critical illness polyneuropathy (CIP) may arise ...
journal_title：Neurocritical care
pub_type： 杂志文章,评审
doi：10.1385/NCC:3:3:195
更新日期：2005-01-01 00:00:00
abstract：BACKGROUND:Target blood pressure (BP) in stable (non-hypotensive) patients with acute isolated blunt traumatic intracranial hemorrhage (TICH) is unknown. To address this issue, our study correlated BP with radiological volumetric progression (RP) and neurological deterioration (ND) in these patients. METHODS:A retrosp...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-014-9957-z
更新日期：2014-08-01 00:00:00
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journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-019-00864-8
更新日期：2020-08-01 00:00:00
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journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-009-9227-7
更新日期：2009-01-01 00:00:00
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journal_title：Neurocritical care
pub_type： 杂志文章,评审
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更新日期：2009-01-01 00:00:00
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journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-016-0257-7
更新日期：2016-12-01 00:00:00
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journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-019-00720-9
更新日期：2020-02-01 00:00:00
abstract：BACKGROUND:Neurogenic pulmonary edema (NPE) is an acute life-threatening complication associated with many forms of central nervous system injury. NPE usually appears within minutes to hours after injury and has a high mortality rate if not recognized and treated appropriately. Lung ultrasound quickly provides at the b...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-013-9828-z
更新日期：2013-06-01 00:00:00
abstract：:Diagnosis of an intracranial aneurysm during pregnancy is a rare event requiring multidisciplinary care for successful management. The knowledge base for the anesthesiologist involves principles of both obstetric and neuroanesthesia, as well as critical care. This article reports such a case and discusses the relevant...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1385/NCC:4:1:018
更新日期：2006-01-01 00:00:00
abstract：BACKGROUND:The effects of induced hypertension (IH) on cerebral perfusion after subarachnoid hemorrhage (SAH) are unclear. The objectives of this investigation are to: (1) determine whether there are differences in cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) measured with compute...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-017-0379-6
更新日期：2017-08-01 00:00:00
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journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-010-9490-7
更新日期：2011-04-01 00:00:00
abstract：BACKGROUND:The management of symptomatic cerebral vasospasm after aneurysmal subarachnoid hemorrhage (aSAH) can be often complicated by the presence of stunned myocardium and left ventricular failure. Vasopressors and inotropes are commonly used to optimize mean arterial pressure (MAP) and cerebral perfusion pressure (...
journal_title：Neurocritical care
pub_type： 杂志文章,评审
doi：10.1007/s12028-010-9358-x
更新日期：2010-08-01 00:00:00
abstract：INTRODUCTION:Despite the recognized deleterious effects of hyperthermia on critically ill neurological patients, few investigations have studied hyperthermia after an ischemic stroke in the intensive care unit (ICU) setting. METHODS:Acute ischemic stroke patients admitted to the ICU were assigned to one of three group...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-008-9056-0
更新日期：2008-01-01 00:00:00
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journal_title：Neurocritical care
pub_type： 杂志文章,随机对照试验
doi：10.1007/s12028-016-0313-3
更新日期：2017-04-01 00:00:00
abstract：:Traumatic brain injury (TBI) was chosen as an Emergency Neurological Life Support topic due to its frequency, the impact of early intervention on outcomes for patients with TBI, and the need for an organized approach to the care of such patients within the emergency setting. This protocol was designed to enumerate the...
journal_title：Neurocritical care
pub_type： 杂志文章,评审
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journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-018-0521-0
更新日期：2018-06-01 00:00:00
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journal_title：Neurocritical care
pub_type： 杂志文章,评审
doi：10.1007/s12028-015-0169-y
更新日期：2015-12-01 00:00:00
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pub_type： 杂志文章
doi：10.1007/s12028-019-00795-4
更新日期：2020-04-01 00:00:00
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journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-014-9981-z
更新日期：2014-10-01 00:00:00
abstract：: ...
journal_title：Neurocritical care
pub_type： 评论,信件
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更新日期：2019-04-01 00:00:00
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journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-018-0631-8
更新日期：2019-04-01 00:00:00
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journal_title：Neurocritical care
pub_type： 杂志文章,评审
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更新日期：2014-02-01 00:00:00
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journal_title：Neurocritical care
pub_type： 杂志文章,评审
doi：10.1007/s12028-011-9568-x
更新日期：2012-02-01 00:00:00
abstract：BACKGROUND:Acute hydrocephalus is a common complication of aneurysmal subarachnoid hemorrhage (aSAH); however, attempts to predict shunt-dependent chronic hydrocephalus using clinical parameters have been equivocal. METHODS:Cohort study of aSAH is treated with external ventricular drainage (EVD) placement at our insti...
journal_title：Neurocritical care
pub_type： 杂志文章
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更新日期：2020-08-01 00:00:00
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journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-007-0042-8
更新日期：2007-01-01 00:00:00
