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VOLUME 22 , ISSUE 2 ( 2018 ) > List of Articles


Recurrent Metabolic Acidosis During High-dose Midazolam Therapy for Refractory Status Epilepticus

Ankur Khandelwal

Keywords : Acidosis, hydrochloric acid, midazolam, seizures

Citation Information : Khandelwal A. Recurrent Metabolic Acidosis During High-dose Midazolam Therapy for Refractory Status Epilepticus. Indian J Crit Care Med 2018; 22 (2):119-121.

DOI: 10.4103/ijccm.IJCCM_416_17

License: CC BY-ND 3.0

Published Online: 01-12-2014

Copyright Statement:  Copyright © 2018; The Author(s).


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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