n South African Journal of Child Health - Effect of prophylactic phenobarbital on seizures, encephalopathy and mortality in neonates with perinatal asphyxia : research
|Article Title||Effect of prophylactic phenobarbital on seizures, encephalopathy and mortality in neonates with perinatal asphyxia : research|
|© Publisher:||Health and Medical Publishing Group (HMPG)|
|Journal||South African Journal of Child Health|
|Affiliations||1 University of the Witwatersrand, 2 University of the Witwatersrand, 3 University of the Witwatersrand and 4 National Laboratory Health Services|
|Publication Date||Feb 2013|
|Pages||17 - 21|
Background. Seizures after an asphyxial insult may result in brain damage in neonates. Prophylactic phenobarbital may reduce seizures.
Objective. To determine the effect of prophylactic phenobarbital on seizures, death and neurological outcome at hospital discharge.
Methods. Neonates with base deficit >16 mmol/l and Apgar score at 5 minutes <7 or requiring resuscitation for >5 minutes at the time of birth were randomised to prophylactic phenobarbital 40 mg/kg (n=50) or placebo (controls) (n=44) within the first 6 hours of life. They were monitored for clinical seizures, hypoxic ischaemic encephalopathy (HIE) and mortality.
Results. Seizures developed in 30.0% of the phenobarbital group as opposed to 47.7% of the control group (relative risk 0.63; 95% confidence interval -0.37 - 1.06; p=0.083). The proportions of patients who had died and/or had HIE II or III at time of discharge from hospital were similar in the two groups (42.0% v. 45.5%). There were no differences in mortality between the two groups (14.0% v. 15.9%).
Conclusion. In infants with asphyxia, prophylactic phenobarbital does not reduce the incidence of seizures, HIE and mortality.
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