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barbituraten bij neurotrauma

barbituraten bij neurotrauma. CAT Rob Rundervoort 4 november 2004. barbituraten bij neurotrauma. zoekmethode: PubMed termen barbit* AND brain limits: clinical trial – 41 hits RCT – 17 hits barbituraten vs. geen barbituraten neurotrauma. barbituraten bij neurotrauma.

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barbituraten bij neurotrauma

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  1. barbituraten bij neurotrauma CAT Rob Rundervoort 4 november 2004

  2. barbituraten bij neurotrauma zoekmethode: • PubMed termen barbit* AND brain • limits: clinical trial – 41 hits RCT – 17 hits • barbituraten vs. geen barbituraten • neurotrauma

  3. barbituraten bij neurotrauma randomized controlled trials - I • Ward 1985 • patiënten met M3 of kleiner (GCS <6) • 27 pentobarbital vs. 26 geen ptb • inclusie ongeacht ICP

  4. barbituraten bij neurotrauma randomized controlled trials – II • Eisenberg 1988 • GCS <=7 • verhoogde ICP ondanks conventionele therapie • 37 pentobarbital vs. 36 geen ptb

  5. barbituraten bij neurotrauma zoeken op reviews: • Roberts I. Barbiturates for acute traumatic brain injury. The Cochrane database of systematic reviews 1999, Issue 3.

  6. barbituraten bij neurotrauma Cochrane review: 5 randomized clinical trials geselecteerd • 1 trial: pentobarbital vs. etomidaat • 1 trial: pentobarbital bv. mannitol • 3 trials: pentobarbital vs. geen ptb

  7. barbituraten bij neurotrauma Bohn DJ et al. Critical Care Medicine 1989;S118:17. • ruwe data niet gepubliceerd • 82 kinderen met GCS <=7 • phenobarbitone vs. no phenobarbitone • quasi-gerandomiseerd

  8. barbituraten en ICP • barbituraten vs. controle • outcome: mean ICP (Ward)

  9. barbituraten en ICP (II) • barbituraten vs. controle • uncontrolled ICP (Eisenberg)

  10. barbituraten en bloeddruk • barbituraten vs. controle • hypotension

  11. barbituraten en overlijden • barbituraten vs. controle • death at the end of follow up

  12. overlijden of ernstige invaliditeit • barbituraten vs. controle • death or disability at follow up

  13. conclusie barbituraten als toevoeging aan conventionele ICP verlagende maatregelen bij neurotrauma: • hebben geen bewezen ICP verlagend effect • resulteren in significant vaker optreden van hypotensie • hebben geen gunstig effect op outcome

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