ArticleJournal of neurotrauma2013
Barbiturates use and its effects in patients with severe traumatic brain injury in five European countries.
Article in Journal of neurotrauma, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 47 citations in OpenAlex.
- Pharmacologic Neuroprotection for Functional Outcomes After Traumatic Brain Injury: A Systematic Review of the Clinical Literature.CNS drugs · 2016Pooled it
- A novel step-down infusion method of barbiturate therapy: Its safety and effectiveness for intracranial pressure control.Pharmacology research & perspectives · 2021Trial
- Evolution from Decompressive Craniectomy to Early Minimally Invasive Surgical Approach for Refractory Increased Intracranial Pressure Treatment: Merit or Social Problems?Turkish journal of anaesthesiology and reanimation · 2025Article
- Pathophysiology-Based Management of Secondary Injuries and Insults in TBI.Biomedicines · 2024Review
- High-Throughput Quantitative LC-MS/MS Analysis of Barbiturates in Human Urine.Methods in molecular biology (Clifton, N.J.) · 2024Article
- Second- and Third-Tier Therapies for Severe Traumatic Brain Injury.Journal of clinical medicine · 2022Review
- Severe Pediatric Traumatic Brain Injury Treatment Approaches of Pediatric Intensivists in Turkey PICUs: National Survey Results.Turkish archives of pediatrics · 2022Article
- Article
- Efficacy of a Novel Prophylactic Barbiturate Therapy for Severe Traumatic Brain Injuries: Step-down Infusion of a Barbiturate with Normothermia.Neurologia medico-chirurgica · 2021Article
- G-computation, propensity score-based methods, and targeted maximum likelihood estimator for causal inference with different covariates sets: a comparative simulation study.Scientific reports · 2020Article
- Early prediction of neurological outcome after barbiturate coma therapy in patients undergoing brain tumor surgery.PloS one · 2019Observational
- Elucidating opportunities and pitfalls in the treatment of experimental traumatic brain injury to optimize and facilitate clinical translation.Neuroscience and biobehavioral reviews · 2018Review
- Analgosedation of adult patients with elevated intracranial pressure : Survey of current clinical practice in Austria.Wiener klinische Wochenschrift · 2018Article
- Nursing Management of Adults with Severe Traumatic Brain Injury: A Narrative Review.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2017Review
- A Fatal Adverse Effect of Barbiturate Coma Therapy: Dyskalemia.Korean journal of neurotrauma · 2016Article
- Traumatic Brain Injury pathophysiology and treatments: early, intermediate, and late phases post-injury.International journal of molecular sciences · 2013Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The guidelines for management of traumatic brain injury (TBI) recommend that high-dose barbiturate therapy may be considered to lower intracranial pressure (ICP) that is refractory to other therapeutic options. Lower doses of barbiturates may be used for sedation of patients with TBI, although there is no mention of this in the published guidelines. The goal of this study was to analyze the use of barbiturates in patients with severe TBI in the European centers where the International Neurotrauma Research Organization introduced guideline-based TBI management and to analyze the effects of barbiturates on ICP, use of vasopressors, and short- and long-term outcome of these patients. Data on 1172 patients with severe TBI were collected in 13 centers located in five European countries. Patients were categorized into three groups based on doses of barbiturates administered during treatment. Univariate and multivariate statistical methods were used to analyze the effects of barbiturates on the outcome of patients. Fewer than 20% of all patients with severe TBI were given barbiturates overall, and only 6% was given high doses. High-dose barbiturate treatment caused a decrease in ICP in 69% of patients but also caused hemodynamic instability leading to longer periods of mean arterial pressure <70 mm Hg despite increased use of high doses of vasopressors. The adjusted analysis showed no significant effect on outcome on any stage after injury.Thiopental and methohexital were equally effective. Low doses of thiopental and methohexital were used for sedation of patients without side effects. Phenobarbital was probably used for prophylaxis of post-traumatic seizures.
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Registered trials
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