Bledsoe Kathleen A, Kramer Andreas H
Department of Pharmacy, University of Virginia Health System, PO Box 800674, Charlottesville, VA 22908-0674, USA.
Neurocrit Care. 2008;9(1):122-4. doi: 10.1007/s12028-008-9065-z.
Barbiturate coma is a necessary medical therapy in certain instances, such as the treatment of refractory status epilepticus or severe intracranial hypertension, but its use is often wrought with serious complications. Potential complications include hemodynamic instability, respiratory depression, and immunosuppression with frequent nosocomial infections. High doses of barbiturates may also lead to the accumulation of propylene glycol, the vehicle used in the intravenous formulations of both pentobarbital and phenobarbital, thereby yielding another less-recognized complication of therapy.
We present a case of propylene glycol toxicity associated with the use of high-dose intravenous pentobarbital and phenobarbital during the treatment of refractory status epilepticus.
巴比妥类药物昏迷疗法在某些情况下是必要的医学治疗手段，例如治疗难治性癫痫持续状态或严重颅内高压，但该疗法的使用常常伴随着严重并发症。潜在并发症包括血流动力学不稳定、呼吸抑制以及因频繁发生医院感染导致的免疫抑制。高剂量的巴比妥类药物还可能导致丙二醇蓄积，丙二醇是戊巴比妥和苯巴比妥静脉制剂中使用的溶媒，从而产生另一种较少被认识到的治疗并发症。
我们报告了一例在难治性癫痫持续状态治疗期间，因使用高剂量静脉注射戊巴比妥和苯巴比妥而导致丙二醇中毒的病例。
