Abstract
A case of heart failure caused by thiopental sodium in an 18-year-old female was reported. She was admitted to the PICU (Pediatric Intensive Care Unit) because of intractable epilepsy which required mechanical ventilation and continuous intravenous infusion of thiopental sodium. Her cardiac function deteriorated (ejection fraction=48%) even though thiopental was tapered off.
The negative inotropic effect of thiopental induced by drug overdose is well known. In this case serum concentration of thiopental was within normal limits for the entire clinical course. The delayed side effect of thiopental appears to have developed as a result of the peculiar pharmacokinetics of thiopental. The tissue concentration of thiopental presumably increased although serum concentration was within the normal range.
It is important to be aware of the possible side effects of thiopental even when the serum concentration of thiopental is normal. Barbiturate therapy should be initiated in the ICU because of this potentially life-threatening cardiorespiratory complication.
