Goldberg 1986.

Methods	Single‐center randomized controlled trial in the US
Participants	Included 32 consecutively admitted term infants with severe perinatal asphyxia [defined as having 2 of 3 criteria (perinatal distress (abnormal fetal heart pattern or requiring prolonged neonatal resuscitation); Apgar score of ≤ 4 at 5 minutes; and base deficit ≥ 15 mEq/L within first hour of life), who had neurologic signs of HIE (decreased or absent response to noxious stimuli, seizure activity, or increased irritability) and required mechanical ventilation within first hour of life without congenital intrauterine infection, complex congenital malformations, or maternal chorioamnionitis
Interventions	Thiopental treatment group (n = 17) received a thiopental loading dose (15 mg/kg IV over 30 minutes), followed by a constant infusion of thiopental (10 mg/kg/hour for 90 minutes, 5 mg/kg/hour for 60 minutes, 3 mg/kg/hour for 8 hours, 1.5 mg/kg/hour for 6 hours, and 0.75 mg/kg/hour for 6 hours) plus conventional therapy Control group (n = 15) received conventional therapy (including fluid restriction, mechanical ventilation, and treatment with phenobarbital or phenytoin for clinical seizure activity)
Outcomes	Primary outcome: reduction of intracranial pressure to the normal range Secondary outcomes: hypotension requiring inotropes, overall effect on neurologic outcome, clinical seizure activity over first 72 hours of life, death, and long‐term neurodevelopmental outcome. Neurodevelopmental assessments were performed at 3, 6, 9, 12, 18, 24, and 36 months using the Bayley Scales of Infant Development and the Stanford‐Binet Intelligence Scale
Notes	Co‐intervention: 14 experimental and 12 control infants received phenobarbital for seizures For follow‐up, both the developmentalist and neurologist were unaware of the infant's treatment regimen
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Assigned using list of random numbers
Allocation concealment (selection bias)	Unclear risk	Method of allocation concealment not specified
Blinding (performance bias and detection bias) All outcomes	High risk	There was no blinding of the treatment team or assessors during hospitalization and no placebo used The follow‐up assessment was blinded
Incomplete outcome data (attrition bias) All outcomes	Low risk	Developmental follow‐up: 1/12 (8%) living infants missing from the intervention group, 1/12 (8%) living infants missing from the control group Neurologic follow‐up: 1/12 (8%) living infants missing from intervention group, 0/12 (0%) living infants missing from the control group
Selective reporting (reporting bias)	Low risk	All outcomes were reported