Capacities of Follow-up of the Severity of Acute Barbiturate Intoxications and their Prediction

Abstract

Seventy-eight patients with moderate, severe, and fatal (n = 12) acute intoxication with barbiturates, as evidenced by the measurements of their blood concentrations were examined. Cardiointervalography was made during follow-up ECG in all the patients in order to determine the tension index (TI), a cumulative measure of the tone of the autonomic nervous system. Comparison of clinical, laboratory, and cardiointervalographic data showed that sympathicotonia (TI, 90—160 conventional units) was predominant in moderate intoxication with barbiturates (their concentration was 16.14±3.2 ^g/ml), there was hypersympathicotonia (TI, more than 160 conventional units) in severe intoxication (the concentration of barbiturates, 30.56±7.6 ^g/ml); the increased tone of the parasympathetic portion of the autonomic nervous system — vagotonia (TI, less than 30 conventional units) in fatal intoxication (the concentration of barbiturates, 37.3±6.6 ^g/ml). Moreover, TI decreased with the age of patients and increased with combined intoxication with barbiturates and alcohol (its blood concentration was more than 1 g/l).