Barbiturate intoxication. Evaluation of therapy including dialysis in a large series selectively referred because of severity

BARBITURATE intoxication continues to be a public health hazard despite improved therapy. Advocates of analeptic,¹,²conservative,³,⁴diuretic,⁵and dialytic therapy⁶have 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