Systematic review of therapy after hypoxic-ischaemic brain injury in the perinatal period.

A Whitelaw

Journal: Seminars in neonatology : SN 2000;5(1):33-40

PMID: 10802748

Full Text on Elsevier Science View on PubMed

Abstract

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.

Address: Division of Child Health, University of Bristol Medical School, Southmead Hospital, Bristol, BS10 5NB, UK. [email protected]

DOI: 10.1053/siny.1999.0113

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MeSH Terms: Allopurinol, Anti-Inflammatory Agents, Anticonvulsants, Asphyxia Neonatorum, Calcium Channel Blockers, Dexamethasone, Diuretics, Osmotic, Fetal Hypoxia, Free Radical Scavengers, Humans, Hypothermia, Induced, Infant, Newborn, Magnesium Sulfate, Mannitol, Naloxone, Perinatal Care, Research Design, Treatment Outcome