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Three Part Question

In term babies with HIE in a low resource setting [patient] does prophylactic phenobarbital [intervention] compared to standard treatment alone reduce mortality or disability [primary outcomes] or reduction in the occurrence of seizures [secondary outcome]

Clinical Scenario

You work in a resource poor country and cooling of infants with Hypoxic Ischaemic Encephalopathy (HIE) is not available. A term baby is born with low Apgar scores and admitted to the neonatal unit, where you confirm moderate to severe HIE. As cooling is not available you wonder if starting phenobarbital (PB) would reduce mortality or disability.

Search Strategy

Cochrane, Pubmed and Embase were searched independently (February 2015) using the search strings (MeSH terms in italics): (Hypoxia-Ischemia, Brain OR Hypoxia, Brain OR hypoxic ischaemic encephalopathy OR hypoxic ischemic encephalopathy OR Encephalopathies, Hypoxic-Ischemic OR HIE OR Asphyxia OR Anoxia OR hypoxia) AND (infant, newborn OR newborn OR Neonatal OR Neonate OR neonates OR newborns) AND (phenobarbital OR phenobarbitone).