| Pentobarbital therapy for intracranial hypertension in metabolic coma. Reye's syndrome. | |
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MedLine Citation:
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PMID: 639524 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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In severe Reye's syndrome, with nonspecific intensive supportive therapy, the mortality rate approaches 75%. In many instances, death is due to uncontrolled cerebral edema and elevated intracranial pressure. (ICP). Pentobarbital therapy, sufficient to maintain a blood barbiturate level between 2.5 mg% and 4.0 mg%, was used to control ICP in seven patients with metabolic coma complicated by intracranial hypertension (intracranial pressure greater than 30 mm Hg for 30 min). The nadir of their neurological function was characterized by no response to deep pain, absent or abnormal oculocephalic responses, bilaterally dilated, unreactive pupils, and markedly irregular or absent respirations. Before barbiturate administration hyperventilation, steroids, mannitol, and other supportive therapies commonly used in Reye's syndrome were begun. After institution of pentobarbital therapy, the daily mannitol dose required to maintain the intracranial pressure below 20 mm Hg was significantly reduced (p less than 0.001), from 3.7 +/- 0.3 to 0.5 +/- 0.2 g/kg/day. All the patients survived, and six have no obvious neurological sequelae. Pentobarbital is a useful adjunct for intracranial pressure control in advanced metabolic coma. |
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Authors:
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L F Marshall; H M Shapiro; A Rauscher; N M Kaufman |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Critical care medicine Volume: 6 ISSN: 0090-3493 ISO Abbreviation: Crit. Care Med. Publication Date: 1978 Jan-Feb |
Date Detail:
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Created Date: 1978-06-17 Completed Date: 1978-06-17 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1-5 Citation Subset: IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Barbiturates / blood Brain Edema / drug therapy* Critical Care Female Humans Intracranial Pressure / drug effects Mannitol / administration & dosage Pentobarbital / therapeutic use* Reye Syndrome / complications*, mortality |
| Chemical | |
Reg. No./Substance:
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0/Barbiturates; 69-65-8/Mannitol; 76-74-4/Pentobarbital |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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