barbiturate coma
Induced deep sedation using barbiturates to reduce cerebral metabolism and intracranial pressure in refractory cases.
Full Definition
Barbiturate coma is a last-resort therapeutic intervention in neurocritical care where high-dose barbiturates (typically pentobarbital or thiopental) are administered to induce a deep comatose state. This treatment dramatically reduces cerebral metabolic rate and oxygen consumption, leading to decreased cerebral blood flow and intracranial pressure. It is reserved for cases of refractory intracranial hypertension that have failed to respond to standard treatments including osmotic therapy, drainage, and positioning. The procedure requires intensive monitoring including EEG burst suppression patterns, hemodynamic support, and careful titration. While potentially life-saving, barbiturate coma carries significant risks including hypotension, cardiac depression, and prolonged recovery times.
Usage
Usage note: Serious intervention requiring careful documentation of indications and monitoring.
In Context
- "Given refractory ICP elevation, the team initiated barbiturate coma with pentobarbital." — ICU progress note
- "Barbiturate coma was discontinued after achieving sustained ICP control." — Neurocritical care plan