Use of barbiturate therapy in severe perinatal asphyxia: A randomized controlled trial

Ronald N. Goldberg, Pedro Moscoso, Charles R. Bauer, Frederick L. Bloom, Richard G. Curless, Barbara Burke, Eduardo Bancalari

Research output: Contribution to journalArticlepeer-review

68 Scopus citations

Abstract

The possible cerebral sparing effect of thiopental was evaluated in 32 severely asphyxiated neonates randomly assigned to either a thiopental treatment or control group. All infants had neurologic manifestations of asphyxia and required assisted ventilation. Thiopental was begun at a mean age of 2.3 hours and was given as a constant infusion that delivered 30 mg/kg over 2 hours. Treatment was continued at a lower dose for 24 hours. Seizure activity occurred in 76% of infants given thiopental and 73% of control infants at a mean age of 1.5 and 2.5 hours, respectively. Although initial arterial blood pressure was similar in both groups, hypotension occurred in 88% of treated and 60% of control infants. The amount of blood pressure support required was significantly greater (P<0.005) in the thiopental treatment group. Three infants died in the control group, and five in the treatment group. Developmental assessment was performed at a minimum of 12 months of age in 22 infants. There were no significant differences in neurologic, cognitive, or motor outcome between groups. Deteriorating performance over time was a consistent trend in both groups. These findings indicate that treatment of severe perinatal asphyxia with thiopental does not appear to have a cerebral sparing effect and may be associated with significant arterial hypotension.

Original languageEnglish (US)
Pages (from-to)851-856
Number of pages6
JournalThe Journal of Pediatrics
Volume109
Issue number5
DOIs
StatePublished - Nov 1986

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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