title: Effect of high-dose phenobarbital on oxidative stress in perinatal asphyxia: an open label randomized controlled trial.
abstract: OBJECTIVE
  To evaluate the effect of high dose phenobarbital on lipid peroxidation and antioxidant enzymes in perinatal asphyxia.
  
  
  METHODS
  Open label, Randomized controlled trial.
  
  
  METHODS
  Neonatal intensive care unit of a tertiary care teaching hospital.
  
  
  METHODS
  72 full term inborn neonates with severe birth asphyxia.
  
  
  METHODS
  Neonates were randomized to Study (phenobarbital) group and Control group. The infants in the study group received phenobarbital infusion (40 mg/kg) within first two hours of life while babies in the control group did not receive any phenobarbital. Rest of the management in both the groups was as per the unit protocol for the management of hypoxic ischemic encephalopathy. A cerebrospinal fluid examination was done at 12 ± 2 hours of life to determine the levels of superoxide dismutase, glutathione peroxidise and malonyldialdehyde. 60 neonates were followed up at 1 month of age when a detailed neurological examination was done.
  
  
  RESULTS
  Four neonates in the study group and six neonates in the control group died during the study. Two neonates in the study group were lost to follow up. The cerebrospinal fluid lipid peroxides and antioxidant enzymes were significantly lower in the phenobarbital group as compared to the control group. The neurological outcome at one month follow up was found to be comparable between the two groups.
  
  
  CONCLUSIONS
  Phenobarbital (40 mg/kg) given in the first two hours of life in term neonates with perinatal asphyxia led to a decrease in CSF levels of lipid peroxides and antioxidant enzymes at 12 ± 2 hours of life.
authors.affiliation: Neonatal Services Division, Department of Pediatrics, Pt BD Sharma PGIMS, Rohtak, India. g _gathwala@hotmail.com
authors.forename: Geeta
authors.initials: G
authors.lastname: Gathwala
authors.forename: Ashish
authors.initials: A
authors.lastname: Marwah
authors.forename: Veena
authors.initials: V
authors.lastname: Gahlaut
authors.forename: Poonam
authors.initials: P
authors.lastname: Marwah
mesh_terms: D001238:Asphyxia Neonatorum / Q000134:cerebrospinal fluid / Q000188:drug therapy* / Q000378:metabolism; D005979:Glutathione Peroxidase / Q000134:cerebrospinal fluid; D006784:Hospitals, Teaching; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000134:cerebrospinal fluid / Q000188:drug therapy* / Q000378:metabolism; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D015227:Lipid Peroxidation / Q000187:drug effects; D008315:Malondialdehyde / Q000134:cerebrospinal fluid; D018696:Neuroprotective Agents / Q000008:administration & dosage*; D018384:Oxidative Stress / Q000187:drug effects*; D010634:Phenobarbital / Q000008:administration & dosage*; D013482:Superoxide Dismutase / Q000134:cerebrospinal fluid
chemical_list: D018696:Neuroprotective Agents; D008315:Malondialdehyde; D005979:Glutathione Peroxidase; D013482:Superoxide Dismutase; D010634:Phenobarbital