Phenobarbital and temperature profile during hypothermia for hypoxic-ischemic encephalopathy.
Data from the whole-body hypothermia trial was analyzed to examine the effects of phenobarbital administration prior to cooling (+PB) on the esophageal temperature (T (e)) profile, during the induction phase of hypothermia. A total of 98 infants were analyzed. At enrollment, +PB infants had a higher rate of severe hypoxic-ischemic encephalopathy and clinical seizures and lower T (e) and cord pH than infants that have not received phenobarbital (-PB). There was a significant effect of phenobarbital itself and an interaction between phenobarbital and time in the T (e) profile. Mean T (e) in the +PB group was lower than in the -PB group, and the differences decreased over time. In +PB infants, the time to surpass target T (e) of 33.5°C and to reach the minimum T (e) during overshoot were shorter. In conclusion, the administration of phenobarbital before cooling was associated with changes that may reflect a reduced thermogenic response associated with barbiturates.
Sant'Anna, G; Laptook, AR; Shankaran, S; Bara, R; McDonald, SA; Higgins, RD; Tyson, JE; Ehrenkranz, RA; Das, A; Goldberg, RN; Walsh, MC; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network,
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