Barbiturate therapy reduces nitrogen excretion in acute head injury

Robert C. Fried, Roland N. Dickerson, Peggi A. Guenter, T. Peter Stein, Thomas A. Gennarelli, Daniel T. Dempsey, Gordon P. Buzby, James L. Mullen

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


The effect of pentobarbital on nitrogen and energy metabolism was evaluated in seven severely head-injured patients (Glasgow Coma Scale 4.7 ± 1.7) within the first week postinjury. Measured energy expenditure (% of predicted) was significantly lower in the pentobarbital group (n = 4) versus control (n = 3) (76 ± 23% versus 132 ± 28%, respectively, p < 0.01). Similarly, 24-hour urinary nitrogen excretion was lower for the barbiturate group compared to control (11.2 ± 4.0 gm versus 19.5 ± 3.3 gm, respectively, p < 0.01). No statistical difference was noted for urinary 3-methylhistidine excretion between the barbiturate and control groups (43 ± 12 mcg/day versus 47 ± 14 mcg/day, respectively, p = N.S.). Barbiturate therapy decreases measured energy expenditure and reduces nitrogen excretion without significantly altering 3-methylhistidine excretion in head-injured patients. The metabolic effects of pentobarbital may enable the ability to achieve energy and nitrogen equilibrium during metabolic support of acutely head-injured patients.

Original languageEnglish (US)
Pages (from-to)1558-1564
Number of pages7
JournalJournal of Trauma - Injury, Infection and Critical Care
Issue number11
StatePublished - Nov 1989

All Science Journal Classification (ASJC) codes

  • Surgery
  • Critical Care and Intensive Care Medicine

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