Thiopental Continuous Infusion in Pediatrics with Refractory Status Epilepticus: A Single-Center Retrospective Study

Background Refractory status epilepticus (RSE) in children is a serious condition that requires prompt intervention and admission to the pediatric intensive care unit (PICU). Continuous intravenous infusion of thiopental has been used with no robust preference recommendations. The purpose of this study was to evaluate the efficacy and safety of continuous thiopental infusion in children with refractory status epilepticus. Methods This was a single center retrospective chart review of children admitted to the PICU with refractory status epilepticus and who received thiopental infusion. Primary outcomes included the efficacy of thiopental infusion in stopping RSE. The secondary outcomes included seizure re-episodes, the PICU length of stay, and the safety of thiopental infusion. Categorical variables are reported as frequencies and percentages. Whereas continuous data was reported as median and interquartile range (IQR). Results Thiopental was given to 11 pediatric patients with RSE as third-line therapy. The majority were male (63.6%), with a median age of 5 years (IQR: 0.2–12). Seizures were confirmed by primarily electroencephalogram (EEG) (54.5%), with an overall seizure duration of 57 hours (IQR: 21–82). Seizure re-episode occurrence after thiopental discontinuation was observed in 3 patients (27.3%). The median (IQR) PICU length of stay was 39 days (13–43), and the hospital length of stay was 49 days (29–160). The PICU mortality rate was reported to be 27.3%. Conclusion Thiopental infusion is a potential treatment option for critically ill pediatric patients with RSE. Larger studies are necessary to determine the implications of thiopental infusion in pediatric patients with RSE, and to compare the findings with other alternative therapies.