[Significance of prolonged barbiturate therapy on severe head injuries--ICP regulation and duration of barbiturate administration].
Barbiturate therapy was performed on 84 head trauma patients which were measured on GCS score of 8 or less, through October 1979 to December 1982. More than 3 g/day of thiamylal or more than 1.5 g/day of pentobarbital were administered for barbiturate therapy. Barbiturate therapy was discontinued in patients whose ICP remained less than 20 mmHg for more than 36 hours. In patients whose ICP sustained higher level, barbiturate was administered continuously until brain death was confirmed or non-filling was recognized. The patients were divided into two groups; Group I in which barbiturate therapy was carried out for 72 hours or less, and Group II in which it was administered for more than 72 hours. The patients in each group were further divided into responder and survivor (a), responder but late death (b), and no-responder or acute brain death (c), As far as age of patients concern, 19 out of 26 patients whose age was less than 20, 22 out of 35 patients whose age was 20-50 and 13 out of 23 patients whose age was more than 50 years responded well to the barbiturate therapy. But one patient died among young age, 4 patients died among middle age and 9 patients died among aged group at later stage. As for Group I (51 patients), Group I a consisted of 22 patients (mean age; 26.2 years, mean GCS score; 6.04, mean initial and maximal ICP; 11.9 and 27.8 mmHg), I b of 8 (52.5 years, 4.75, 17.0 and 27.8 mmHg), and I c of 21 (41.4 years, 4.57, 38.1 and 98.0 mmHg respectively).(ABSTRACT TRUNCATED AT 250 WORDS)
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001463:Barbiturates / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use; D001930:Brain Injuries / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003128:Coma / Q000209:etiology; D005260:Female; D006801:Humans; D007223:Infant; D007427:Intracranial Pressure / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013997:Time Factors
D001463:Barbiturates