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Respiratory Complications in Low-Birth-Weight Infants Who Received Phenobarbital

Respiratory Complications in Low-Birth-Weight Infants Who Received Phenobarbital Abstract • We compared the ventilatory requirements of 127 infants who received phenobarbital for five days with those of 111 infants who received placebo. All infants were intubated, weighed less than 1750 g at birth, and survived the first ten days of life. Those infants who received phenobarbital did not require ventilatory assistance for more days than did placebo receivers. However, a pneumothorax or pulmonary interstitial emphysema was more likely to develop in infants who received phenobarbital than in infants who received placebo, even when adjustment was made for the presence of subependymal-intraventricular hemorrhage. We believe this is the first report of this relationship and recommend additional studies to test the hypothesis that phenobarbital contributes to the occurrence/recognition of pneumothorax or pulmonary interstitial emphysema in very-low-birth-weight infants if phenobarbital continues to be used routinely as prophylaxis or treatment. (AJDC 1987;141:996-999) References 1. Bedard MP, Shankaran S, Slovis TL, et al: Effect of prophylactic phenobarbital on intraentricular hemorrhage in high-risk infants . Pe[ill]iatrics 1984;73:435-439. 2. Donn SM, Roloff DW, Goldstein GW: Pre[ill]ention of intraventricular hemorrhage in pre[ill]erm infants by phenobarbitone . Lancet 1981;2: 15-217. 3. Hope PL, Stewart AL, Thornburn RJ, et al: [ill]ailure of phenobarbitone to prevent intraven[ill]ricular hemorrhage in small preterm infants . [ill]ancet 1982;2:444-445. 4. Morgan MEI, Massey RF, Cooke RWI: [ill]oes phenobarbitone prevent periventricular [ill]emorrhage in very low-birthweight babies? A [ill]ontrolled trial . Pediatrics 1982;70;186-189. 5. Whitelaw A, Placzek M, Dubowitz L, et al: [ill]henobarbitone for prevention of periventricular haemorrhage in low birth weight infants: A randomised double-blind trial . Lancet 1983;2:1168-1170.Crossref 6. Kuban KCK, Leviton A, Krishnamoorthy KS, et al: Neonatal intracranial hemorrhage and phenobarbital . Pediatrics 1986;77:443-450. 7. Mantel N, Haenszel W: Statistical aspects of the analysis of data from retrospective studies of disease . JNCI 1959;22:719-748. 8. Miettinen O: Estimability and estimation in case-referent studies . Am J Epidemiol 1976;103: 226-235. 9. Baker RJ, Nelder JA: The GLIM System . Oxford, England, Royal Statistical Society, 1978. 10. Bishop YMM, Fienberg SE, Holland PW: Discrete Multivariate Analysis: Theory and Practice . Cambridge, Mass, MIT Press, 1975, pp 57-122. 11. Cooke RWI, Rennie JM: Pancuronium and pneumothorax . Lancet 1984;1:286-287.Crossref 12. Greenough A, Wood S, Morley CJ, et al: Pancuronium prevents pneumothoraces in ventilated premature babies who actively expire against positive pressure inflation . Lancet 1984; 1:1-3.Crossref 13. Mayo P, Saha SP: Spontaneous pneumothorax in the newborn . Am Surg 1983;49:192-195. 14. Stark AR, Bascom R, Frantz ID III: Muscle relaxation in mechanically ventilated infants . J Pediatr 1979;94:439-443.Crossref 15. Feinstein AR, Horwitz RI: Double standards, scientific methods and epidemiologic research . N Engl J Med 1982;307:1611-1617.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1987 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1987.04460090073030
Publisher site
See Article on Publisher Site

Abstract

Abstract • We compared the ventilatory requirements of 127 infants who received phenobarbital for five days with those of 111 infants who received placebo. All infants were intubated, weighed less than 1750 g at birth, and survived the first ten days of life. Those infants who received phenobarbital did not require ventilatory assistance for more days than did placebo receivers. However, a pneumothorax or pulmonary interstitial emphysema was more likely to develop in infants who received phenobarbital than in infants who received placebo, even when adjustment was made for the presence of subependymal-intraventricular hemorrhage. We believe this is the first report of this relationship and recommend additional studies to test the hypothesis that phenobarbital contributes to the occurrence/recognition of pneumothorax or pulmonary interstitial emphysema in very-low-birth-weight infants if phenobarbital continues to be used routinely as prophylaxis or treatment. (AJDC 1987;141:996-999) References 1. Bedard MP, Shankaran S, Slovis TL, et al: Effect of prophylactic phenobarbital on intraentricular hemorrhage in high-risk infants . Pe[ill]iatrics 1984;73:435-439. 2. Donn SM, Roloff DW, Goldstein GW: Pre[ill]ention of intraventricular hemorrhage in pre[ill]erm infants by phenobarbitone . Lancet 1981;2: 15-217. 3. Hope PL, Stewart AL, Thornburn RJ, et al: [ill]ailure of phenobarbitone to prevent intraven[ill]ricular hemorrhage in small preterm infants . [ill]ancet 1982;2:444-445. 4. Morgan MEI, Massey RF, Cooke RWI: [ill]oes phenobarbitone prevent periventricular [ill]emorrhage in very low-birthweight babies? A [ill]ontrolled trial . Pediatrics 1982;70;186-189. 5. Whitelaw A, Placzek M, Dubowitz L, et al: [ill]henobarbitone for prevention of periventricular haemorrhage in low birth weight infants: A randomised double-blind trial . Lancet 1983;2:1168-1170.Crossref 6. Kuban KCK, Leviton A, Krishnamoorthy KS, et al: Neonatal intracranial hemorrhage and phenobarbital . Pediatrics 1986;77:443-450. 7. Mantel N, Haenszel W: Statistical aspects of the analysis of data from retrospective studies of disease . JNCI 1959;22:719-748. 8. Miettinen O: Estimability and estimation in case-referent studies . Am J Epidemiol 1976;103: 226-235. 9. Baker RJ, Nelder JA: The GLIM System . Oxford, England, Royal Statistical Society, 1978. 10. Bishop YMM, Fienberg SE, Holland PW: Discrete Multivariate Analysis: Theory and Practice . Cambridge, Mass, MIT Press, 1975, pp 57-122. 11. Cooke RWI, Rennie JM: Pancuronium and pneumothorax . Lancet 1984;1:286-287.Crossref 12. Greenough A, Wood S, Morley CJ, et al: Pancuronium prevents pneumothoraces in ventilated premature babies who actively expire against positive pressure inflation . Lancet 1984; 1:1-3.Crossref 13. Mayo P, Saha SP: Spontaneous pneumothorax in the newborn . Am Surg 1983;49:192-195. 14. Stark AR, Bascom R, Frantz ID III: Muscle relaxation in mechanically ventilated infants . J Pediatr 1979;94:439-443.Crossref 15. Feinstein AR, Horwitz RI: Double standards, scientific methods and epidemiologic research . N Engl J Med 1982;307:1611-1617.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Sep 1, 1987

References