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Recurrent Metabolic Acidosis during High-dose Midazolam Therapy for Refractory Status Epilepticus
Shalendra Singh1, Ankur Khandelwal1, Rashmi Datta2
1Department of Neuroanaesthesia, AIIMS, New Delhi, India.
Abstract:
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.
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