Severe Hypothermia as a Result of Barbiturate Overdose Complicated by Cardiac Arrest

Fell, R. H.; Gunning, A. J.; Bardhan, Karna Dev; Triger, D. R.

doi:10.1016/s0140-6736(68)91357-3

Cited by 71 publications

(11 citation statements)

References 11 publications

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“…These can result from extravascular injection or prolonged external compression, both of which may be accompanied by rhabdomyolysis [6, 7]. Other well-described clinical features of barbiturate overdose are hypothermia and cardiovascular collapse, with bradycardia and refractory hypotension [8]. Furthermore, respiratory depression or embarrassment may be evident in the barbiturate-poisoned patient unlike other sedative-hypnotic medications, such as benzodiazepines.…”

Section: Discussionmentioning

confidence: 99%

Pentobarbital Toxicity after Self-Administration of Euthasol Veterinary Euthanasia Medication

Crellin

Katz

2016

Case Reports in Emergency Medicine

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Suicide attempt via sodium pentobarbital is uncommon. A 48-year-old woman with a history of depression and prior suicide attempt was found unresponsive by her veterinarian spouse near a syringe containing pink solution. Upon EMS' arrival, the patient was experiencing apnea, hypoxemia, and miotic pupils; her blood glucose level measured 73 mg/dL. She was bradycardic and administered atropine with transient improvement in heart rate and transported to an emergency department; 2 mg of intravenous naloxone was administered without effect. She was endotracheally intubated via rapid sequence intubation. Rapid urine drug screening detected both benzodiazepines and barbiturates. The patient was transferred to an intensive care unit where she demonstrated a nearly absent radial pulse. Emergent fasciotomy to the left forearm and carpal tunnel was performed for acute compartment syndrome; “Euthasol” had been self-administered into the antecubital fossa. Expanded toxicological analysis via liquid chromatography/mass spectroscopy detected caffeine, atropine, 7-aminoclonazepam, phenytoin, citalopram, and naproxen. The patient's coma resolved over 48 hours and she was successfully extubated without complication. Emergency physicians must closely monitor patients exposed to veterinary euthanasia agents who develop central nervous system and respiratory depression, hypothermia, bradycardia, hypotension, or skin injury. Consultation with a regional poison center and medical toxicologist is recommended.

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Section: Discussionmentioning

confidence: 99%

Pentobarbital Toxicity after Self-Administration of Euthasol Veterinary Euthanasia Medication

Crellin

Katz

2016

Case Reports in Emergency Medicine

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“…6 Since then, multiple other case reports have been reported in the literature. 2,7 –9 While toxic concentrations of barbiturates have been correlated to cause hypothermia, this was not the case in this patient as she was always found to have therapeutic phenobarbital levels. However, one of the limitations includes a lack of documented medication administration in regard to timing of drug levels to validate the appropriateness of the drug levels.…”

Section: Discussionmentioning

confidence: 76%

“…Numerous case reports have described hypothermia with barbiturates, usually in the setting of overdose. 2,[5][6][7][8][9] Lee and Ames first documented an incidence of hypothermia in *50% of barbiturate overdoses in a 1965 case series that was mostly associated with short-acting barbiturates. 5 In 1966, another case reported noted severe hypothermia of 23 C with an overdose of 50 capsules of sodium amylobarbitone.…”

Section: Discussionmentioning

confidence: 99%

Recurrent Admissions for Hypothermia From Concomitant Topiramate and Phenobarbital: A Case Report

Mutch

2017

Journal of Pharmacy Practice

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“…Since the first case of deep accidental hypothermia successfully rewarmed by extracorporeal circulation [1], this technique has gained widespread acceptance [2 ± 4]. Several parameters at rescue time have been reported to be of prime importance for the survival [5,6]: depth of hypothermia, absence of asphyxia, young age, infrastructure and experience of rescue organisation, rewarming technique.…”

Section: Discussionmentioning

confidence: 99%

Unusual Complications After Rewarming for Deep Accidental Hypothermia

Vionnet¹,

Mueller²,

Lk³

2004

Thorac cardiovasc Surg

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Deep accidental hypothermia is an uncommon pathology. Successful management has been reported in isolated cases, but the majority of patients die from complications after rewarming. We report on a patient with deep accidental hypothermia after a mountaineering accident. He was successfully rewarmed with cardiopulmonary bypass, but presented several complications which led to death. These complications included the patient developing acute peritonitis and necrotizing fasciitis, which represent, to our knowledge, complications that have never been associated with deep accidental hypothermia before.

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Severe Hypothermia as a Result of Barbiturate Overdose Complicated by Cardiac Arrest

Cited by 71 publications

References 11 publications

Pentobarbital Toxicity after Self-Administration of Euthasol Veterinary Euthanasia Medication

Pentobarbital Toxicity after Self-Administration of Euthasol Veterinary Euthanasia Medication

Recurrent Admissions for Hypothermia From Concomitant Topiramate and Phenobarbital: A Case Report

Unusual Complications After Rewarming for Deep Accidental Hypothermia

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