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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Comparar la eficacia del pentobarbital y tiopental en el control de la hipertensi&#243;n intracraneal &#40;HIC&#41; refractaria a las medidas de primer nivel&#44; seg&#250;n las Gu&#237;as de Pr&#225;ctica Cl&#237;nica de la &#8220;Brain Trauma Foundation&#8221;&#44; en pacientes con traumatismo craneoencef&#225;lico &#40;TCE&#41; grave&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio prospectivo de cohorte&#44; aleatorizado&#44; de intervenci&#243;n terap&#233;utica comparativa entre dos f&#225;rmacos&#58; pentobarbital y tiopental&#46; La muestra fue seleccionada a partir de los pacientes que sufrieron un TCE grave &#40;Glasgow Coma Scale GCS&#44; postresucitaci&#243;n&#44; &#8804;8 puntos o deterioro neurol&#243;gico en la primera semana post traumatismo&#41; y que presentaron HIC &#40;PIC &#62;20<span class="elsevierStyleHsp" style=""></span>mmHg&#41; refractaria al tratamiento convencional&#44; de acuerdo con las Gu&#237;as de Pr&#225;ctica Cl&#237;nica de la &#8220;Brain Trauma Foundation&#8221;&#46; Adem&#225;s de comprobar la eficacia en el control de la PIC&#44; tambi&#233;n se recogieron los efectos secundarios del tratamiento&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se presentan los resultados de los primeros 20 pacientes reclutados&#44; de los cuales diez recibieron tiopental y diez pentobarbital&#46; No hubo diferencias estad&#237;sticamente significativas en las caracter&#237;sticas b&#225;sales de los pacientes &#40;edad&#44; sexo&#44; &#237;ndices de gravedad y comorbilidades&#41;&#46; Tampoco hubo diferencias respecto al GCS de ingreso &#40;tiopental seis puntos&#59; pentobarbital siete puntos&#59; P<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;26&#41; ni en la tomograf&#237;a craneal computarizada de ingreso&#44; seg&#250;n la clasificaci&#243;n del &#8220;Traumatic Coma Data Bank&#8221;&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">En el grupo de tiopental se control&#243; la PIC en cinco casos y en el grupo de pentobarbital en dos pacientes &#40;P<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;16&#41;&#46; Cinco pacientes tratados con tiopental fallecieron y ocho en el grupo de pentobarbital &#40;P<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;16&#41;&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">No hubo diferencias significativas entre ambos grupos respecto a la incidencia de hipotensi&#243;n arterial &#40;P<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>l&#41; o complicaciones infecciosas&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">los resultados preliminares de este estudio indican que el tiopental podr&#237;a ser m&#225;s eficaz que el pentobarbital en el control de la HIC refractaria a las medidas de primer nivel&#46; Dichos resultados confirman la evidencia experimental que indica que los mecanismos neuroprotectores de ambos f&#225;rmacos son distintos y justifican el continuar aumentando el tama&#241;o muestral de nuestro estudio para poder definir mejor la eficacia de ambos f&#225;rmacos&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">To assess the effectiveness of pentobarbital and thiopental to control raised intracranial pres-sure &#40;ICP&#41;&#44; refractory to first level measures&#44; in patients with severe traumatic brain injury&#46;</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Prospective&#44; randomized study to compare the effectiveness between two treat-ments&#58; pentobarbital and thiopental&#46; The patients will be selected from those admitted to the Intensive Care Unit with a severe traumatic brain injury &#40;postresusci-tation Glasgow Coma Scale equal or less than 8 points&#41; and raised ICP &#40;ICP&#62;20<span class="elsevierStyleHsp" style=""></span>mmHg&#41; refractory to first level measures according to the Brain Trauma Foundation guidelines&#46; The adverse effeets of both treatments were also collected&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">We present the results of the first 20 patients included&#46; Ten received pentobarbital and the other ten thiopental&#46; There were no statistically significance differences in patients&#8217;characteristics &#40;age&#44; sex&#44; severity of the trauma at admission and comorbilities&#41;&#46; There were no differences between both groups neither in the Glasgow Coma Scale at admission &#40;thiopental six points&#59; pentobarbital seven points&#59; P&#61;0&#44;26&#41; &#241;or in the admission Cranial Tomography&#44; according to the Trau-matic Coma Data Bank classi&#241;cation&#46;</p><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Thiopental treatment controlled raised ICP in flve cases and pentobarbital in two cases &#40;P&#61;0&#44;16&#41;&#46; Five patients in the thiopental group died and eight in the pentobarbital group &#40;P&#61;0&#44;16&#41;&#46;</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">There were no statistically differences between both groups regarding to the presence of hypotension &#40;P&#61;l&#41; or infectious complications&#46;</p><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Conclusions&#46; These preliminary results ind&#237;cate that thiopental could be more effective than pentobarbital in patients with refractory intracranial hypertension&#46; These results support previous experimental &#241;ndings that show that both treatments are not equal and justify to continu&#233; this study&#46;</p>"
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Comparación de la eficacia del pentobarbital y el tiopental en el control de la hipertensión intracraneal refractaria. Resultados preliminares en una serie de 20 pacientes
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Servicio de Medicina Intensiva. Hospital Son Dureta. Palma Mallorca. Departament de Cirurgia. Universitat Autónoma. Barcelona
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** Servicios de de Neurología. Hospital Son Dureta. Palma Mallorca
*** Servicio de Medicina Interna. Hospital Son LLatzer. Palma Mallorca
**** Servicio de Neurocirugía. Hospital Valí d’Hebrón. Barcelona

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