title: Randomized controlled trial of magnesium sulfate infusion for severe birth asphyxia.
abstract: OBJECTIVE
  To determine whether postnatal MgSO(4) infusion (250 mg/kg per day) for 3 days is both safe and able to improve outcome in infants with severe birth asphyxia, as had been suggested by a small pilot study.
  
  
  METHODS
  A multicenter randomized controlled trial was conducted. Entry criteria included 5-min Apgar score of seven or less and either failure to initiate spontaneous respiration at 10 min after birth because of asphyxia, or occurrence of clinically apparent seizures within 24 h after birth. Number of subjects was calculated to detect a 50% reduction in incidence of adverse outcomes.
  
  
  RESULTS
  Distributions of perinatal factors, neonatal baseline characteristics and severity of hypoxic-ischemic encephalopathy were similar in treated and control groups. No significant differences were observed in duration of clinical seizures, or need for assisted ventilation. Survival with normal results of cranial computed tomography, electroencephalography and establishment of oral feeding by 14 days of age, was significantly more frequent in the treated group than in the control group (12/17 vs 5/16, P = 0.04). No significant differences in blood pressure, heart rate or respiratory rate were observed between groups.
  
  
  CONCLUSIONS
  Postnatal MgSO(4) infusion as above is safe and can improve short-term outcome in infants with severe birth asphyxia.
authors.affiliation: Department of Pediatrics, Osaka City University Graduate School of Medicine, Osaka, Japan. h-ichiba@med.osaka-cu.ac.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ichiba
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tamai
authors.forename: Hirokuni
authors.initials: H
authors.lastname: Negishi
authors.forename: Toru
authors.initials: T
authors.lastname: Ueda
authors.forename: Tae-Jang
authors.initials: TJ
authors.lastname: Kim
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Sumida
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Hideshi
authors.initials: H
authors.lastname: Fujinaga
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Minami
mesh_terms: D001238:Asphyxia Neonatorum / Q000188:drug therapy*; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000517:prevention & control*; D007231:Infant, Newborn; D008278:Magnesium Sulfate / Q000008:administration & dosage / Q000627:therapeutic use*; D013997:Time Factors
chemical_list: D008278:Magnesium Sulfate