J Neurointensive Care.  2022 Oct;5(2):60-65. 10.32587/jnic.2022.00549.

Comparison Between Complications of Pentothal Coma Therapy and Targeted Temperature Management in Traumatic Brain Injury Patients

• Lee KY
• Kim JH
• Park DH

• KMID: 2555069
• DOI: http://doi.org/10.32587/jnic.2022.00549

Abstract

Background
Pentothal coma therapy (PCT) and targeted temperature management (TTM) are considered the most aggressive medical care for patients with severe traumatic brain injury (TBI). However, there is very little comparison between these two options. We compared the survival rates and complications between the two treatments.
Methods
Nineteen patients who received treatment for PCT or TTM after severe TBI between March 2018 and April 2022 were retrospectively enrolled. Medical records were reviewed, including general information, neurologic status, treatment courses, survival rate, and complications. Patients were divided into two groups according to the treatment modalities (PCT vs. TTM), and comparison analyses were conducted.
Results
The survival rate in the TTM group was 33.3% (3/9), which was higher than that in the PCT group (1/10, 10%). However, this difference was not significant (p = 0.213). In terms of complications, there were no statistically significant differences in hemodynamic instability, cardiovascular disability, hepatic dysfunction, renal dysfunction, pneumonia, urinary tract infection, hyperkalemia, hypokalemia, coagulopathy, or hyperglycemia. Commonly observed complications included hypokalemia in the TTM group (100% in the TTM group vs 70% in the PCT group; p = 0.073) and hyperkalemia in the PCT group (50% in the PCT group vs 11.1% in the TTM group; p = 0.069).
Conclusion
Severe TBI patients treated with TTM has non-significantly lower mortality than them with PCT (66.7% vs. 90%); however, complications of hypokalemia can be frequently observed (100%). Further study was necessary to evaluate the efficacy and safety of TTM.

Keyword

Hypothermia; Pentothal coma; Traumatic brain injury; Thiopental sodium; Therapeutic target management