Barbiturate Coma After Severe TBI

The idea of putting patients into a barbiturate coma after serious TBI in order to reduce the intracranial pressure (ICP) has been around for years. It has been controversial, and a new study (Majdan, M et al. 2012 ) showed that in five European treatment centers, while high dose barbiturates decrease ICP in 69% of patients, it also caused longer periods of pressure instability, which is exceedingly dangerous. The analysis showed no significant effect on outcome at any stage after injury. Probably not worth doing.