SUPER-refractory Status Epilepticus After Cardiac Arrest: Multicenter Retrospective Cohort Study of Dual Anti-glutamate Therapy With Ketamine and Perampanel

What this Trial Is About

Status epilepticus (SE) occurs in 20-30% of patients in coma after cardiac arrest and is often resistant to treatment, leading to poor outcomes. This study investigates the effectiveness and safety of a combined anti-glutamatergic therapy using ketamine and perampanel for treating super-refractory post-anoxic SE. The research aims to compare this dual therapy to other antiseizure and anesthetic treatments, addressing uncertainty about optimal care for this condition through a multicenter, retrospective cohort design. The study compares two groups: one receiving ketamine intravenously for 3 days with doses adjusted by EEG monitoring, combined with oral perampanel for 5 days via nasogastric tube, followed by gradual dose reduction; and a control group receiving standard antiseizure and anesthetic therapies excluding ketamine and perampanel. The research involves multiple Italian hospitals and focuses on patients with super-refractory status epilepticus after cardiac arrest, selected based on neurological prognostic indicators. Participants' care is observed retrospectively without intervention changes. Data collected include EEG patterns, neurological outcomes during Intensive Care Unit stays, and 6-month post-cardiac arrest results. Researchers measure status epilepticus resolution, neurological recovery, mortality, and safety indicators such as cholestasis and cardiac events. The study's findings will guide future treatment strategies and potential randomized trials.

Dual Anti-glutamate Therapy in Super-refractory Status Epilepticus After Cardiac Arrest