Fig. 2
From: Valproic acid as adjuvant treatment for convulsive status epilepticus: a randomised clinical trial
Timing of second-line anti-seizure medicine (ASM) (panel A) and sedation and serum concentrations of valproic acid (VPA) (panel B). Panel A, data were available for 241 patients (3 missing in each group) for second-line ASM (2nd-line ASM) and 229 (6 and 9 missing in the placebo and VPA groups) for sedation, by propofol, midazolam, or pentothal for at least 6 h. Even if mainly used for synchronisation with the ventilator, sedative drugs were taken into account because of their anti-epileptic properties. Panel B, whole blood concentrations are presented for the 22 VPA group participants with samples, before VPA administration (“Before”), 15 min after loading dose administration (“15 min”) and 15 min after the end of the 12-h continuous intravenous infusion (“12 h + 15 min”). The grey shaded region represents the therapeutic interval, expressed as mg/L of whole blood. One patient received VPA before hospital admission. Baseline sampling was performed after VPA administration in two patients. For note, the plasma/whole blood ratio of valproic acid is about 1.8 [40]