title: Pentobarbital-Induced Myocardial Stunning in Status Epilepticus Requiring Extracorporeal Membrane Oxygenation: A Case Report and Literature Review.
abstract: Introduction. Mild hypotension is a well-recognized complication of intravenous pentobarbital; however fulminant cardiopulmonary failure has not been previously reported. Case Report. A 28-year-old woman developed pentobarbital-induced cardiopulmonary failure that was successfully treated with maximal medical management including arteriovenous extracorporeal membrane oxygenation. She made an excellent cardiopulmonary and neurological recovery. Discussion and Conclusion. Pentobarbital is underrecognized as a potential cause of myocardial stunning. The mechanism involves direct myocardial depression and inhibition of autonomic neuroanatomical structures including the medulla and hypothalamus. Early recognition and implementation of aggressive cardiopulmonary support are essential to optimize the likelihood of a favorable outcome.
authors.affiliation: Cedars-Sinai Medical Center, 127 South San Vicente Boulevard, Suite A6600, Los Angeles, CA 90048, USA.
authors.forename: Tapan
authors.identifier: 0000-0002-6242-340X
authors.initials: T
authors.lastname: Kavi
authors.affiliation: Cedars-Sinai Medical Center, 127 South San Vicente Boulevard, Suite A6600, Los Angeles, CA 90048, USA.
authors.forename: Donna
authors.initials: D
authors.lastname: Molaie
authors.affiliation: Cedars-Sinai Medical Center, 127 South San Vicente Boulevard, Suite A6600, Los Angeles, CA 90048, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Nurok
authors.affiliation: Cedars-Sinai Medical Center, 127 South San Vicente Boulevard, Suite A6600, Los Angeles, CA 90048, USA.
authors.forename: Axel
authors.initials: A
authors.lastname: Rosengart
authors.affiliation: Cedars-Sinai Medical Center, 127 South San Vicente Boulevard, Suite A6600, Los Angeles, CA 90048, USA.
authors.forename: Shouri
authors.initials: S
authors.lastname: Lahiri