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Related Experiment Videos

Thiopentone induced coma after severe birth asphyxia.

J A Eyre, A R Wilkinson

    Archives of Disease in Childhood
    |November 1, 1986
    PubMed
    Summary

    Inducing prolonged coma with high-dose thiopentone in newborn babies after severe asphyxia is feasible but did not improve outcomes. Complications were frequent, with survivors experiencing moderate to severe handicaps.

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    Area of Science:

    • Neonatalogy
    • Pediatric Critical Care
    • Clinical Pharmacology

    Background:

    • Severe neonatal asphyxia poses significant risks to newborns.
    • Therapeutic coma is sometimes considered for managing brain injury in neonates.
    • High-dose barbiturates like thiopentone are used for inducing coma.

    Purpose of the Study:

    • To assess the feasibility of inducing prolonged coma using high-dose thiopentone in severely asphyxiated newborns.
    • To monitor electroencephalograph (EEG) and blood pressure during thiopentone infusion.
    • To evaluate the safety and efficacy of this intervention.

    Main Methods:

    • Six severely asphyxiated newborns received continuous EEG and blood pressure monitoring.
    • Thiopentone infusion aimed for complete EEG suppression, maintaining mean blood pressure >35 mm Hg.
    • Infusion continued until 24 hours without cerebral edema evidence.

    Main Results:

    • Deep coma was maintained for a median of 127 hours in four infants.
    • Two infants required premature cessation of infusion due to unresponsive hypotension.
    • All infants developed pharmacodynamic tolerance to thiopentone; three died, and three survivors had moderate to severe handicaps.

    Conclusions:

    • Inducing deep coma in severely asphyxiated newborns with thiopentone is possible with intensive care.
    • This intervention did not appear to improve clinical outcomes.
    • High incidence of complications and adverse effects were observed.

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