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Decrease in white blood cell counts after thiopentone barbiturate therapy for refractory intracranial hypertension: A

Shin Yi Ng1, Ki Jinn Chin, Tong Kiat Kwek

  • 1Department of Anaesthesiology, Singapore General Hospital, Singapore, Republic of Singapore.

Journal of Neurosciences in Rural Practice
|November 1, 2013
PubMed
Summary
This summary is machine-generated.

A decrease in white blood cell (WBC) count is common after thiopentone barbiturate coma, but severe leucopenia is rare. Regular monitoring of WBC counts is recommended for patients receiving this therapy.

Keywords:
Barbiturate comaleucopeniatraumatic brain injury

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Area of Science:

  • Neurology
  • Critical Care Medicine
  • Pharmacology

Background:

  • Thiopentone barbiturate therapy is used for refractory intracranial hypertension.
  • Leucopenia has been anecdotally reported following this treatment.
  • The incidence and characteristics of leucopenia require further description.

Purpose of the Study:

  • To determine the incidence of leucopenia after thiopentone barbiturate therapy.
  • To characterize the changes in white blood cell (WBC) counts.
  • To identify potential risk factors associated with WBC count decrease.

Main Methods:

  • Retrospective review of patients receiving thiopentone barbiturate therapy for intracranial hypertension.
  • Data collected over an 18-month period (January 2004 - June 2005).
  • Statistical analysis using SPSS, including Chi-square and t-tests.

Main Results:

  • Eighty-one percent (38/47) of patients showed a decrease in WBC count (mean decrease 6.4 × 10(9)/L).
  • The nadir WBC count occurred 57 hours post-induction (mean 8.6 ± 3.6 × 10(9)/L).
  • Only 6.4% (3/47) of patients developed leucopenia; none were neutropenic. No association found with infection or risk factors.

Conclusions:

  • Decreased WBC count is a frequent finding after thiopentone-induced coma.
  • Clinically significant leucopenia is uncommon.
  • Monitoring of WBC counts is advised for patients undergoing this treatment.