Barbiturate coma for intracranial hypertension: clinical observations.
OBJECTIVE
To determine the neurologic outcome of patients with intracranial hypertension treated with barbiturate-induced coma.


METHODS
The records of 49 patients who were admitted to a 31-bed medicosurgical intensive care unit over a 5-year period in whom a barbiturate coma was induced to control intracranial hypertension were analyzed retrospectively. Analysis included assessment of the response to barbiturate coma and evaluation of the long-term neurologic outcome according to the Glasgow Outcome Scale (GOS).


RESULTS
Intracranial hypertension was caused by head trauma in 28 patients and subarachnoid hemorrhage in 21 patients. Eight of the head trauma patients and 5 of the patients with subarachnoid hemorrhage survived their hospital stay. The survivors were younger than the nonsurvivors, and had a good neurologic status after 1 year (except for 2 patients who died 1 and 3 months after discharge, respectively). There was no significant difference in the Glasgow Coma Score (GCS) on admission between the survivors and the nonsurvivors. The long-term outcome at 1 year was markedly better in the patients who had experienced a subarachnoid hemorrhage than in the trauma patients.
Dereeper
Etienne
E
Department of Anesthesiology, Erasme Hospital, Free University of Brussels, Belgium.
Berré
Jacques
J
Vandesteene
Arlette
A
Lefranc
Florence
F
Vincent
Jean-Louis
JL
D000293:Adolescent; D000328:Adult; D001463:Barbiturates / Q000009:adverse effects* / Q000627:therapeutic use*; D001530:Belgium; D002648:Child; D003128:Coma / Q000139:chemically induced*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007362:Intensive Care Units; D019586:Intracranial Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
D001463:Barbiturates