Bowel ischemia: a rare complication of thiopental treatment for status epilepticus.

Détails

ID Serval
serval:BIB_C7F731462DA5
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Titre
Bowel ischemia: a rare complication of thiopental treatment for status epilepticus.
Périodique
Neurocritical Care
Auteur(s)
Cereda C., Berger M.M., Rossetti A.O.
ISSN
1541-6933[print], 1541-6933[linking]
Statut éditorial
Publié
Date de publication
05/2009
Volume
10
Numéro
3
Pages
355-358
Langue
anglais
Résumé
BACKGROUND: Refractory status epilepticus (RSE) treatment is usually performed with coma induction using an appropriate general anesthetic. Most frequent complications are represented by hypotension and infection. Other side-effects may however be encountered. OBSERVATIONS: We describe two patients suffering from acute bowel ischemia after thiopental (THP) treatment for RSE. A 73-year-old man with a complex-patial RSE following an acute stroke received THP (303 mg/kg over 48 h); 36 h after THP discontinuation, he presented abdominal tenderness and lactate elevation. Necrosis of the terminal ileum and colon was seen during surgical exploration; he deceased shortly thereafter. A 21 year-old woman had a cryptogenic de novo generalized-convulsive RSE resistant to 5 attempts of EEG burst-suppression. During the 6th attempt, after THP (840 mg/kg over 150 h) together with mild hypothermia, she developed an ileus with elevated serum lactate; caecum necrosis was observed during surgery. Hypernatremia, acidosis and hyperlactatemia heralded this complication in both patients. CONCLUSION: In these two patients, mechanical vascular ischemia may have resulted from drug-induced paralytic ileus. To our knowledge, this is the first report describing this potential fatal side effect in adults with RSE.
Mots-clé
Aged, Anticonvulsants/adverse effects, Cecum/blood supply, Colon/blood supply, Female, Humans, Ischemia/chemically induced, Ischemia/diagnosis, Male, Status Epilepticus/drug therapy, Thiopental/adverse effects, Young Adult
Pubmed
Web of science
Création de la notice
13/05/2009 17:15
Dernière modification de la notice
03/03/2018 21:20
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