Hazards of high dose barbiturate therapy in head-injury patients

Despite of controversial findings, High-Dose-Barbiturate Therapy is advocated by many authors for treatment of postischemic/anoxic encephalopathy and head trauma with elevated intracranial pressure. The adverse effects to thiopentone are analyzed in a retrospective study including 30 patients treated by high-dose thiopentone for raised intracranial pressure after severe head injury. The pathophysiology and occurrence of clinical complications in many systems of the organism are illustrated. The specific prevention measures and the extended monitoring of barbiturate-treated patients are described. Considering the high incidence of clinical complications the indication for HDBT has to be reevaluated.