High-dose thiopental pharmacokinetics in brain-injured children and neonates.
High-dose thiopental pharmacokinetics in brain-injured children and neonates.
复制标题
高剂量硫喷妥钠在脑损伤儿童和新生儿中的药代动力学。
DOI：
10.1159/000457755
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发表时间：
1987
期刊：
影响因子：
--
通讯作者：
A. Brachet
中科院分区：
文献类型：
--
作者：
J. Demarquez;R. Galpérine;C. Billeaud;A. Brachet
应用大剂量硫喷妥钠治疗难治性惊厥或缺氧性脑病患儿8例(A组)，足月新生儿窒息7例(B组)。所有患者均接受人工过度换气，以维持二氧化碳分压接近3.5kPa.直肠温度维持在35℃左右，硫喷妥钠滴注速度2~4 mg×h~(-1)×kg~(-1)，A组32~192h(平均103h)，B组36~48h(平均38.5h)。血药浓度-时间数据进行药代动力学分析。硫喷妥钠消除半衰期为14.5h(A组)和20.9h(B组)。硫喷妥钠清除量分别为0.27升×h~(-1)×kg~(-1)和0.32升×h~(-1)×kg~(-1)。稳态分布容量分别为5.41L×kg-1(A组)和8.26L X kg-1(B组)。这些结果表明，大剂量硫喷妥钠在足月新生儿、儿童和成人中的药代动力学没有太大差异。与单剂研究相比，消除半衰期和分布体积有所改变，而清除量仅略有改变。硫喷妥钠从血液中消失的时间也很长(2至5天)。考虑到蓄积和毒性的风险，在可能长时间使用硫喷妥钠的情况下，这些药代动力学特征值得考虑。
High-dose thiopental was administered in 8 children with uncontrollable seizures or hypoxic encephalopathy (group A) and 7 full-term neonates with neonatal asphyxia (group B). All of them were submitted to artificial hyperventilation to maintain pCO2 near 3.5 kPa. Rectal temperature was kept at about 35 degrees C. Thiopental was infused with a rate of 2-4 mg X h-1 X kg-1, with treatment lasting 32-192 h for group A (mean 103 h), and 36-48 h for group B (mean 38.5 h). Plasma concentration-time data were analysed pharmacokinetically. Thiopental elimination half-life was 14.5 h (group A) and 20.9 h (group B). The clearance of thiopental was 0.27 liters X h-1 X kg-1 (group A) and 0.32 liters X h-1 X kg-1 (group B). The volume of distribution at steady-state was 5.41 liters X kg-1 (group A) and 8.26 liters X kg-1 (group B). These results show that high-dose thiopental pharmacokinetics is not very different for full-term newborns, children and adults. Elimination half-life and volume of distribution are changed when compared to single-dose studies, while clearance is only slightly modified. The time for disappearance of thiopental from blood is also very long (2 to 5 days). These pharmacokinetic characteristics would be worthy of consideration in cases where there may be prolonged use of thiopental, considering the risk of accumulation and toxicity.