Evaluation of Feeding Intolerance in Patients with Pentobarbital-Induced Coma
| Autor: | Karen Frock, Alison M Stevens, Christopher Commichau, Bonnie J Beynnon, Brian T Marden, Bruce A. Crookes, Jill A. Rebuck, Janine E Then |
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| Rok vydání: | 2008 |
| Předmět: |
Adult
Male Pentobarbital Adolescent medicine.drug_class Critical Illness medicine.medical_treatment Enteral administration Hypnotic Enteral Nutrition medicine Animals Humans Pharmacology (medical) Coma Aged Retrospective Studies Aged 80 and over Gastric emptying business.industry Feeding Behavior Middle Aged Induced coma Parenteral nutrition Brain Injuries Anesthesia Sedative Female medicine.symptom business Adjuvants Anesthesia medicine.drug |
| Zdroj: | Annals of Pharmacotherapy. 42:516-522 |
| ISSN: | 1542-6270 1060-0280 |
| DOI: | 10.1345/aph.1k555 |
| Popis: | BACKGROUND: There is considerable debate regarding the appropriateness of feeding patients by the enteral route in conjunction with pentobarbital coma therapy. OBJECTIVE: To determine the incidence of feeding intolerance (FI) in patients receiving pentobarbital in conjunction with enteral nutrition (EN). METHODS: A retrospective, observational evaluation of patients (>14 y of age) who received a therapeutic pentobarbital coma in combination with EN was conducted. Patients were divided into groups, based on the occurrence of FI defined as aspiration of gastric residuals greater than 75 mL for 2 consecutive measurements. RESULTS: Forty-eight percent (29 of 61) of patients experienced FI based on our definition. The median pentobarbital infusion rate did not differ significantly between patients who experienced FI versus those who did not (median [intraquartile range, IQR] 1.8 mg/kg/h [1.4, 2.1] vs 1.7 mg/kg/h [1.4, 2.5]; p = 0.680). The total pentobarbital bolus dose during the first 24 hours of therapy was lower in patients who experienced FI (700 mg [225, 980] vs 1000 mg [600, 1475]; p = 0.029). Median duration of pentobarbital therapy was comparable between groups (141.0 h [93.3, 217.3] vs 116.3 h [64.0, 174.8]; p = 0.115). Other factors with the potential to influence FI, such as catecholamines, neuromuscular blockade, and hyperglycemia, were similar between groups. The higher narcotic doses and greater percentage of patients receiving benzodiazepines in the FI group warrants further study. CONCLUSIONS: Pentobarbital therapy did not preclude use of EN in the entire study population. In addition, FI did not occur at a greater frequency in patients who received a higher dosage, a longer duration, or an earlier initiation of pentobarbital therapy. |
| Databáze: | OpenAIRE |
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