Antiseizure Drug Could be Fatal (in 32 (82 percent) of the patients (grou...)

Antiseizure Drug Could be Fatal

Date:10/28/2008

in 32 (82 percent) of the patients (group A) for a median of 63 hours and a median peak infusion rate of 67 mcg/kg/min. Other agents, such as midazolam and pentobarbital, were used in the other seven (18 percent) patients (group B). Within group A, three patients had sudden unexplained cardiac arrest while on propofol infusions, resulting in two deaths, while no deaths occurred in group B. Median hospital stay (12 days) and ICU length of stay (9 days) did not differ between the two groups. The overall occurrence of PRIS was 30 percent of patients in group A (seven patients with bradycardia, three patients with sudden unexplained cardiac arrest) compared with less than 3 percent (one patient with bradycardia) in group B.

In light of the new data, Dr. Iyer advises that caution should be taken with the use of propofol to treat patients with RSE. "There are several other medications we can turn to in the case of uncontrolled seizures," he said. "Alternative agents should first be tried for patients with RSE, and propofol should only be used after exhausting all other options."

"With increasing awareness of the risks of propofol, physicians may become more cautious about using propofol for prolonged periods and at high doses," said James A. L. Mathers, Jr., MD, FCCP, President of the American College of Chest Physicians.

CHEST 2008 is the 74th annual international scientific assembly of the American College of Chest Physicians, held October 25-30 in Philadelphia, PA. ACCP represents 17,000 members who provide patient care in the areas of pulmonary, critical care, and sleep medicine in the United States and throughout the world. The ACCP's mission is to promote the prevention and treatment of diseases of the chest through leadership, education, research, and communication. For more information about the ACCP, please visit the ACCP Web site at http://www.chestnet.org.

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