Outcome in severe Reye syndrome with early pentobarbital coma and hypothermia

Abstract

THE ETIOLOGY of Reye syndrome remains unknown and therefore specific therapy is unavailable. Although many cases are mild, death in severe cases often occurs secondary to the encephalopathy and cerebral swelling, ~,2 which lead to a rise in intracranial pressure and progressive cerebral ischemia.3, 4 Some of the more recent therapies proposed to control brain swelling in RS are pentobarbital-induced coma 5 and hypothermia 6 for the reduction of cerebral substrate demand, blood flow, and intracranial hypertension. In January, 1979, in an effort to control the cerebral swelling and improve outcome, we introduced a treatment protocol calling for the institution of pentobarbital coma and hypothermia in severely affected children without waiting for a rise in ICP. Our results with this prophylactic regimen are compared with our earlier experience.