Abstracts

Rationale: Acute seizures are common in critically ill children. These patients would benefit from intravenous anti-seizure medications with few adverse effects. We reviewed the usage and effects of intravenous lacosamide in critically ill children. Methods: This is a single-center retrospective case series of consecutive patients admitted to the pediatric intensive care unit at a quaternary care pediatric hospital from 4/11 – 2/16 administered IV lacosamide for treatment of seizures. This cohort was separated into those with new lacosamide initiation and those who continued outpatient lacosamide. Dosing and prescribing practices were reviewed. Adverse effects (cardiopulmonary events, and lab abnormalities) were defined by set criteria, and most were evaluated during the full admission. Results: Forty-seven patients over 51 intensive care unit admissions were administered IV lacosamide. Twenty-nine (62%) patients had not received lacosamide prior to admission; in this cohort, it was the third or fourth line anti-seizure medication administered for acute seizures or status epilepticus. Adverse effects were only noted in the lacosamide-naïve cohort. One patient experienced bradycardia and one patient experienced a rash that were considered potentially related to lacosamide. No other adverse effects were identified, including no evidence of PR interval prolongation. Conclusions: Lacosamide was well tolerated in critically ill children with acute seizures. Further study is warranted to evaluate the effectiveness of earlier lacosamide use for pediatric status epilepticus and acute seizures. Funding: Investigator Initiated Grant from UCB Pharma