Complications associated with barbiturate therapy

Role of barbiturate coma in the management of focally induced, severe cerebral edema in children

“…4,9 Work in the 1980s suggested a potential neuroprotective effect of barbiturates, 5,17 although few recent data have emerged to support this effect. Infection, although frequently described with barbiturate therapy, 16,20 did not appear to be a serious complication in this small group. Of the 5 instances in which we used pentobarbital therapy, we encountered a Klebsiella urinary tract infection, which was detected 1 day after the discontinuation of barbiturates, and C. albicans infections of the urine and blood in a different patient after her first surgery at 11 and 25 days following pentobarbital therapy.…”

“…22 There is evidence of a dose-dependent correlation between barbiturate therapy and infection rates, possibly explaining our relative avoidance of this complication. 6,20 Finally, each patient exhibited some degree of mild to moderate hypothermia during pentobarbital therapy. However, each responded well to warming blankets as needed, and no discernible complications were identified.…”

Role of barbiturate coma in the management of focally induced, severe cerebral edema in children

“…4,9 Work in the 1980s suggested a potential neuroprotective effect of barbiturates, 5,17 although few recent data have emerged to support this effect. Infection, although frequently described with barbiturate therapy, 16,20 did not appear to be a serious complication in this small group. Of the 5 instances in which we used pentobarbital therapy, we encountered a Klebsiella urinary tract infection, which was detected 1 day after the discontinuation of barbiturates, and C. albicans infections of the urine and blood in a different patient after her first surgery at 11 and 25 days following pentobarbital therapy.…”

“…22 There is evidence of a dose-dependent correlation between barbiturate therapy and infection rates, possibly explaining our relative avoidance of this complication. 6,20 Finally, each patient exhibited some degree of mild to moderate hypothermia during pentobarbital therapy. However, each responded well to warming blankets as needed, and no discernible complications were identified.…”

Ventilator-Associated Pneumonia in Pediatric Traumatic Brain Injury

“…We believe this association between VAP, NMBA, barbiturate coma, and cooling to euthermia is likely due to prevention of patient-initiated coughing and secretion clearance, as well as the immune suppressant effect of barbiturates. [31][32][33] Limitation of the use of these therapies to only those with ICP elevation threatening herniation may be reasonable to decrease rates of VAP in this population.…”

Anti‐inflammatory and immune‐mediated therapy for a case of febrile infection‐related epilepsy syndrome with rapid recurrence

“… 2 Multiple AEDs (valproate sodium, levetiracetam, topiramate, phenytoin) in different combinations were administered under respiratory management. Barbiturates, including phenobarbital, have severe side effects 3 , 4 ; they caused the patient’s serum alanine aminotransferase levels to rise to 1839 U/L. High‐dose PHB was discontinued.…”

Role of barbiturate coma in the management of focally induced, severe cerebral edema in children

“…4,9 Work in the 1980s suggested a potential neuroprotective effect of barbiturates, 5,17 although few recent data have emerged to support this effect. Infection, although frequently described with barbiturate therapy, 16,20 did not appear to be a serious complication in this small group. Of the 5 instances in which we used pentobarbital therapy, we encountered a Klebsiella urinary tract infection, which was detected 1 day after the discontinuation of barbiturates, and C. albicans infections of the urine and blood in a different patient after her first surgery at 11 and 25 days following pentobarbital therapy.…”

“…22 There is evidence of a dose-dependent correlation between barbiturate therapy and infection rates, possibly explaining our relative avoidance of this complication. 6,20 Finally, each patient exhibited some degree of mild to moderate hypothermia during pentobarbital therapy. However, each responded well to warming blankets as needed, and no discernible complications were identified.…”

Ventilator-Associated Pneumonia in Pediatric Traumatic Brain Injury

“…We believe this association between VAP, NMBA, barbiturate coma, and cooling to euthermia is likely due to prevention of patient-initiated coughing and secretion clearance, as well as the immune suppressant effect of barbiturates. [31][32][33] Limitation of the use of these therapies to only those with ICP elevation threatening herniation may be reasonable to decrease rates of VAP in this population.…”

Anti‐inflammatory and immune‐mediated therapy for a case of febrile infection‐related epilepsy syndrome with rapid recurrence

“… 2 Multiple AEDs (valproate sodium, levetiracetam, topiramate, phenytoin) in different combinations were administered under respiratory management. Barbiturates, including phenobarbital, have severe side effects 3 , 4 ; they caused the patient’s serum alanine aminotransferase levels to rise to 1839 U/L. High‐dose PHB was discontinued.…”

Role of barbiturate coma in the management of focally induced, severe cerebral edema in children

“…4,9 Work in the 1980s suggested a potential neuroprotective effect of barbiturates, 5,17 although few recent data have emerged to support this effect. Infection, although frequently described with barbiturate therapy, 16,20 did not appear to be a serious complication in this small group. Of the 5 instances in which we used pentobarbital therapy, we encountered a Klebsiella urinary tract infection, which was detected 1 day after the discontinuation of barbiturates, and C. albicans infections of the urine and blood in a different patient after her first surgery at 11 and 25 days following pentobarbital therapy.…”

“…22 There is evidence of a dose-dependent correlation between barbiturate therapy and infection rates, possibly explaining our relative avoidance of this complication. 6,20 Finally, each patient exhibited some degree of mild to moderate hypothermia during pentobarbital therapy. However, each responded well to warming blankets as needed, and no discernible complications were identified.…”

Ventilator-Associated Pneumonia in Pediatric Traumatic Brain Injury

“…We believe this association between VAP, NMBA, barbiturate coma, and cooling to euthermia is likely due to prevention of patient-initiated coughing and secretion clearance, as well as the immune suppressant effect of barbiturates. [31][32][33] Limitation of the use of these therapies to only those with ICP elevation threatening herniation may be reasonable to decrease rates of VAP in this population.…”

Anti‐inflammatory and immune‐mediated therapy for a case of febrile infection‐related epilepsy syndrome with rapid recurrence

“… 2 Multiple AEDs (valproate sodium, levetiracetam, topiramate, phenytoin) in different combinations were administered under respiratory management. Barbiturates, including phenobarbital, have severe side effects 3 , 4 ; they caused the patient’s serum alanine aminotransferase levels to rise to 1839 U/L. High‐dose PHB was discontinued.…”