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February 1966

Barbiturate Intoxication: Evaluation of Therapy Including Dialysis in a Large Series Selectively Referred Because of Severity

Author Affiliations


From the Department of Medicine, Georgetown University School of Medicine and the Renal and Electrolyte Division, Georgetown University Hospital, Washington, DC. Dr. Setter is presently at the Renal Section, Medical College of Virginia, Richmond, Va.

Arch Intern Med. 1966;117(2):224-236. doi:10.1001/archinte.1966.03870080068011

BARBITURATE intoxication continues to be a public health hazard despite improved therapy. Advocates of analeptic,1,2 conservative,3,4 diuretic,5 and dialytic therapy 6 have presented their respective cases, without producing a universally accepted approach to therapy. A high annual mortality persists.

This report presents information gained from the study of severe barbiturate poisoning. It is particularly valuable because: (1) all patients were studied in depth by the Renal and Electrolyte Division of Georgetown University Hospital, rather than reviewed in a record room series; (2) they were selectively referred because of severity; (3) the study includes a long-term evaluation of therapy by hemodialysis, recent experience with peritoneal dialysis and a program of forced diuresis and a period of trial with analeptics; and (4) unlike other studies most of our patients took short-acting barbiturates.

Case Material  One hundred and seventy-three cases of barbiturate intoxication were studied in 163 patients between February