The use of urea-induced diuresis and alkalization of the urine is described for the treatment of severe barbiturate intoxication with compounds of slow spontaneous elimination. These patients represented only a small percentage of the total number with acute barbiturate intoxication hospitalized during the 2 years of this study. An average diuresis of 12.1 liters of alkaline urine per 24 hours was obtained in 57 patients; the average duration of treatment was 42 hours, with a calculated reduction of duration of coma to about one-third. Diuretic treatment was found to reduce mortality and frequency of tracheostomy to 50% of those in an untreated control group. The treatment, relatively simple and with few complications, can be considered a valuable adjunct to the fundamental supportive therapy in severe cases of barbiturate poisoning.
Andrej Myschetzky, Niels Alexander Lassen. Urea-Induced, Osmotic Diuresis and Alkalization of Urine in Acute Barbiturate Intoxication. JAMA. 1963;185(12):936–942. doi:10.1001/jama.1963.03060120046020