| Home | E-Submission | Sitemap | Editorial Office |  
top_img
Journal of Korean Neurosurgical Society 1986;15(3): 381-394.
Therapeutic Barbiturate Coma in Uncontrolled Intracranial Hypertension : Management of Patients and Effect on Outcome.
Chun Kun Park, Jang Hoe Whang, Dal Soo Kim, Sang Won Lee, Moon Chan Kim, Joon Ki Kang
Department of Neurosurgery, Catholic Medical College, Korea.
ABSTRACT
In spite of high-dose, hyperventilation, hyperosmolar agents, appropriate surgical evacuation, and cerebrospinal fluid when possible, uncontrolled intracranial hypertension, which was defined as occurring when intracranial pressure(ICP) exceeded 25 mmHg for 2 hours or more, occurred in 8 patients. Persistent elevated ICP occurred in 4 patient with acute subdural hematoma and brain contusion, in 2 patients with aneurysm and brain infarction, in 1 patient with hypertensive intracerebral hematoma, and in 1 patient with meningioma. All of these patients received intravenous barbiturate to control the ICP. The initial thiopental loading dose(10mg/kg) effectively reduced the ICP in 5 patients(62.5%). In those patients responding to the initial loading dose, four have survived, and one died due to pulmonary complication. None of three nonresponders to barbiturate survived. Two of the survivors have returned to a productive life, and two ramain moderately disabled. The favorable outcome in this series suggests that early aggresive treatment of intracranial hypertension with barbiturate and careful attention to medical complications can improve the outcome in patients with uncontrolled intracranial hypertension, with barbiturate and careful attention to medical complications can improve the outcome in patients with uncontrolled intracranial hypertension, especially in postoperative state. A broader investigation of the clinical application of barbiturates in indicated.
Key Words: Intracranial hypertension; Barbiturate; Thiopental; Outcome
Editorial Office
1F, 18, Heolleung-ro 569-gil, Gangnam-gu, Seoul, Republic of Korea
TEL: +82-2-525-7552   FAX: +82-2-525-7554   E-mail: kns61@neurosurgery.or.kr
About |  Browse Articles |  Current Issue |  For Authors and Reviewers
Copyright © Korean Neurosurgical Society.                 Developed in M2PI
Close layer