Refractory hypokalemia during barbiturate coma therapy used for treating refractory intracranial hypertension in traumatic brain injury
Barbiturate coma therapy (BCT) is a choice treatment for refractory intracranial hypertension after all surgical or medical managements have failed to control the intracranial pressure (ICP). It helps to reduce cerebral blood flow, cerebral metabolic rate of oxygen consumption and ICP. However, this therapy can also cause many complications. One of the underreported, but life-threatening complications is refractory hypokalemia, which can lead to subsequent rebound hyperkalemia after sudden cessation. We report our experience of managing unusual complication of refractory hypokalemia during BCT with thiopentone in postdecompressive craniectomy patient.
Abstract A new kinetic approach is presented to study the mechanism of the catalytic reaction of the hydrogenation of carbon monoxide on Fe–Co–Mn catalyst prepared by wet impregnation method over MgO support. The experimental data obtained by a fixed bed reactor are used for calculating the apparent activity energy of the LHHW kinetic models developed for the consumption of carbon monoxide, and formation of methane, alkenes and alkanes. Then, using the calculated activation energies and the available UBI–QEP relationships for the ternary catalyst and obtaining the relationships between the apparent activity energy of the LHHW kinetic model and the activity energy of surface elementary reactions involved in the kinetic equation extraction and by developing an appropriate software coupled with a genetic optimization algorithm, the surface binding energy of carbon, oxygen and hydrogen on the ternary catalyst are calculated.