Phenobarbital and temperature profile during hypothermia for hypoxic-ischemic encephalopathy

J Child Neurol. 2012 Apr;27(4):451-7. doi: 10.1177/0883073811419317. Epub 2011 Sep 29.

Abstract

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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Anticonvulsants / therapeutic use*
  • Body Temperature / drug effects
  • Body Temperature / physiology
  • Cold Temperature
  • Female
  • Humans
  • Hypothermia, Induced / methods*
  • Hypoxia-Ischemia, Brain / therapy*
  • Infant
  • Male
  • Phenobarbital / therapeutic use*
  • Time Factors
  • Treatment Outcome

Substances

  • Anticonvulsants
  • Phenobarbital