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Báo cáo y học: "Barbiturates for the treatment of intracranial hypertension after traumatic brain injury"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Barbiturates for the treatment of intracranial hypertension after traumatic brain injury. | Available online http ccforum.eom content 12 5 185 Commentary Barbiturates for the treatment of intracranial hypertension after traumatic brain injury Sarice L Bassin and Thomas P Bleck Department of Neurology Northwestern University Feinberg School of Medicine N Lake Shore Drive Chicago Illinois 60611 USA Corresponding author Sarice L Bassin sbassin@nmff.org Published 20 October 2008 This article is online at http ccforum.com content 12 5 185 2008 BioMed Central Ltd Critical Care 2008 12 185 doi 10.1186 cc7020 See related research by Pérez-Bárcena et al. http ccforum.com content 12 4 R112 Abstract In their article on the use of barbiturates for the treatment of intracranial hypertension after traumatic brain injury Perez-Barcena and colleagues conclude that thiopental was more effective than pentobarbital in decreasing intracranial pressure. Here we discuss the limitations of this study and review areas of controversy surrounding barbiturate use in neurocritical care. Raised intracranial pressure ICP after traumatic brain injury TBI is common and associated with increased risk for death and disability. Despite decades of animal and human research successful prevention and treatment of this deadly complication largely eludes the medical community. Because of the considerable heterogeneity and severity of the disease well designed prospective randomized studies in neurotrauma are rare. All academic attempts to generate reliable trial data are noteworthy. In this context we enthusiastically applaud Pérez-Bárcena and colleagues 1 for their thoughtful and ambitious research. The study evaluates the use of two barbiturates pentobarbital and thiopental in the treatment of refractory intracranial hypertension after TBI. Forty-four patients were randomly assigned to receive pentobarbital or thiopental after first-level measures had failed to control ICP. In the pentobarbital and thiopental groups ICP was controlled in 18 and 50 of patients respectively without any .