• Barbiturate poisoning was treated in 243 patients, of whom 160 were comatose on admission to the hospital and 18 required mechanical respirator. The state of the reflexes was at times a confusing criterion of the depth of poisoning. The immediate danger was generally respiratory; the patient's airway was cleared scrupulously, and every step taken to insure adequate intake of oxygen. The circulatory management, in deeply comatose patients, included the starting of venoclysis at the time of admission to provide an immediate route if plasma expanders or vasopressor drugs became necessary. The four patients who were not saved all proved to have serious underlying medical problems in addition to the barbiturate poisoning. Their histories are given with four others to illustrate various principles of treatment. Hemodialysis used in one of these cases removed 890 mg. of barbiturates from the circulation of a deeply comatose patient who made a complete recovery. The use of analeptic drugs and electrical stimulation afforded little additional help and did not provide an adequate substitute for the direct physiological treatment of depressed respiration or circulation.
Plum F, Swanson AG. BARBITURATE POISONING TREATED BY PHYSIOLOGICAL METHODSWITH OBSERVATIONS ON EFFECTS OF BETA, BETA-METHYLETHYLGLUTARIMIDE AND ELECTRICAL STIMULATION. JAMA. 1957;163(10):827–835. doi:10.1001/jama.1957.02970450029008