Systematic review of therapy after hypoxic-ischaemic brain injury in the perinatal period.
Objectives were to identify and to evaluate controlled trials of interventions for term infants developing hypoxic-ischaemic encephalopathy. Five randomized trials concerning prophylactic anticonvulsant therapy for neonatal HIE were identified. There were methodological problems with all of them, and meta-analysis of barbiturate prophylaxis showed no significant effect on death or disability. One randomized trial of allopurinol showed short-term benfits, but was too small to test death or disability. One small randomized trial of hypothermia found no adverse effects, but was too small to examine death or disability. No adequate trials of dexamethasone, calcium channel blockers, magnesium sulphate, or naloxone have yet been completed, but pilot studies in infants have shown the risks of magnesium sulphate and calcium channel blockers.
Whitelaw
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Division of Child Health, University of Bristol Medical School, Southmead Hospital, Bristol, BS10 5NB, UK. andrew.whitelaw@bristol.ac.uk
D000493:Allopurinol / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D001238:Asphyxia Neonatorum / Q000150:complications / Q000401:mortality / Q000628:therapy*; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D004234:Diuretics, Osmotic / Q000627:therapeutic use; D005311:Fetal Hypoxia / Q000150:complications / Q000401:mortality / Q000628:therapy*; D016166:Free Radical Scavengers / Q000627:therapeutic use; D006801:Humans; D007036:Hypothermia, Induced; D007231:Infant, Newborn; D008278:Magnesium Sulfate / Q000627:therapeutic use; D008353:Mannitol / Q000627:therapeutic use; D009270:Naloxone / Q000627:therapeutic use; D018743:Perinatal Care / Q000379:methods*; D012107:Research Design; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D000927:Anticonvulsants; D002121:Calcium Channel Blockers; D004234:Diuretics, Osmotic; D016166:Free Radical Scavengers; D009270:Naloxone; D008353:Mannitol; D000493:Allopurinol; D008278:Magnesium Sulfate; D003907:Dexamethasone