Open AccessRecurrent Metabolic Acidosis During High-dose Midazolam Therapy for Refractory Status Epilepticus
Author(s) -
Shalendra Singh,
Ankur Khandelwal,
Rashmi Datta,
Ashutosh Kaushal,
Gyaninder Pal Singh
Publication year - 2018
Publication title -
indian journal of critical care medicine/indian journal of critical care medicine
Language(s) - Uncategorized
Resource type - Journals
SCImago Journal Rank - 0.317
H-Index - 30
eISSN - 1998-359X
pISSN - 0972-5229
DOI - 10.4103/ijccm.ijccm_416_17
Subject(s) - medicine , midazolam , status epilepticus , metabolic acidosis , refractory (planetary science) , complication , anesthesia , acidosis , metabolic disorder , surgery , epilepsy , sedation , physics , psychiatry , astrobiology
High-dose continuous midazolam therapy has been used successfully for control of refractory status epilepticus. However, normal anion gap (AG) metabolic acidosis, a deleterious complication of this therapy is underrecognized. Even though previously reported in an isolated case report in a pediatric patient, we observed similar complication in an adult patient. Stereotyped normal AG metabolic acidosis along with hypotension developed on two occasions during high-dose continuous midazolam hydrochloride infusion that reverted rapidly following cessation of the infusion.