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February 1989

Phenobarbital and Respiratory Complications in Neonates Receiving Mechanical Ventilatory Support

Author Affiliations

NICU, Department of Pediatrics Hadassah University Hospital Mt Scopus Jerusalem 91240, Israel

Am J Dis Child. 1989;143(2):138. doi:10.1001/archpedi.1989.02150140020005

Sir.—Kuban et al1 have reported an increased occurrence of pneumothorax and interstitial emphysema in infants of low birth weight receiving mechanical ventilatory support who also received phenobarbital sodium as prophylaxis for intraventricular hemorrhage. No reference was made, however, to the possibility of such an association in term infants.

Phenobarbital is routinely used in our unit to treat neonatal seizures occurring after severe perinatal asphyxia.2 Since mechanical ventilatory support is often applied in such instances to prevent brain swelling or to treat associated lung disease, we decided to review the records of such term infants for the occurrence of iatrogenic pulmonary complications.

During the past seven years, 11 neonates received phenobarbital in our unit while receiving mechanical ventilatory support without having prior iatrogenic respiratory complications. Gestational ages ranged from 37 to 42 weeks and birth weights ranged from 2060 to 4700 g. All of the infants suffered from

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