Barbiturates reduce ICP by suppressing cerebral metabolism and, correspondingly, CBF. They do this both directly and by reducing seizure activity. Both pentobarbital and thiopental have been used to induce barbiturate coma. Their use is usually reserved for those patients whose intracranial hypertension has been refractory to other treatments. Similar to other sedatives, thiopental use is associated with systemic hypotension and should only be used in normovolemic patients. Two randomized controlled trials have assessed the efficacy of thiopentone for the treatment of raised ICP in patients with head injury. One trial showed a reduction in ICP that was significantly greater in the group treated with barbiturates, but with no improvement in long-term outcome. The second trial found that the ICP was controlled in approximately one-third of the treatment group, and that in those patients who responded, long-term outcome was also improved. A proportion of patients treated with barbiturates show no decrease in ICP. This may be due to uncoupling of cerebral metabolic rate of oxygen consumption from CBF, and is an indicator of poor prognosis.

Blood Pressure Health

Blood Pressure Health

Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...

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