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Limitations of Theophylline in the Treatment of Apnea of Prematurity

Limitations of Theophylline in the Treatment of Apnea of Prematurity Abstract • Theophylline is commonly used to treat apnea of prematurity. To determine the effectiveness of theophylline with respect to gestational and postnatal age, we conducted a controlled study in 43 premature infants with idiopathic apnea. Three of the 21 treated and eight of the 22 control infants developed respiratory failure. Eight of the 11 infants with respiratory failure had gestational ages of less than 31 weeks and had more than four apneic episodes during the first day of life. In the treated infants without respiratory failure, the number of apneic episodes by 24-hour intervals declined six days earlier than in the control infants. Apnea disappeared, however, at a similar time in both groups. Three treated infants and three control infants had apneic episodes persisting beyond the neonatal period. Patients treated with theophylline did not develop respiratory failure as often as control infants did. However, despite a reduction of apneic episodes, theophylline did not shorten the course of apnea of prematurity. (AJDC 1985;139:567-570) References 1. Peabody JL, Neese AL, Philip AGS, et al: Transcutaneous oxygen monitoring in aminophylline-treated apneic infants . Pediatrics 1978; 62:698-701. 2. Hiatt IM, Hegyi T, Indyk L, et al: Continuous monitoring of PO2 during apnea of prematurity . J Pediatr 1981;98:288-291.Crossref 3. Daily WJR, Klaus M, Meyer HBP: Apnea in premature infants: Monitoring incidence, heart rate changes, and an effect of environmental temperature . Pediatrics 1969;43:510-517. 4. Rigatto H: Apnea and periodic breathing . Semin Perinatol 1977;1:375-381. 5. Cooke RWI, Rolfe P, Howat P: Apparent cerebral blood flow in newborns with respiratory disease . Dev Med Child Neurol 1979;21:154-160.Crossref 6. Kuzemko JA, Paala J: Apneoic attacks in the newborn treated with aminophylline . Arch Dis Child 1973;48:404-406.Crossref 7. Shannon DC, Gotay F, Stein IM, et al: Prevention of apnea and bradycardia in low-birthweight infants . Pediatrics 1975;55:589-594. 8. Uauy R, Shapiro DL, Smith B, et al: Treatment of severe apnea in prematures with orally administered theophylline . Pediatrics 1975;55: 595-598. 9. Bednarek FJ, Roloff DW: Treatment of apnea of prematurity with aminophylline . Pediatrics 1976;58:335-339. 10. Rigatto H: Apnea . Pediatr Clin North Am 1982;29:1105-1106. 11. Kattwinkel J: Neonatal apnea: Pathogenesis and therapy . J Pediatr 1977;90:342-347.Crossref 12. Schulte FJ: Apnea . Clin Perinatol 1977;4: 65-76. 13. Gerhardt T, Bancalari E: Apnea of prematurity: I. Lung function and regulation of breathing . Pediatrics 1984;74:58-62. 14. Gerhardt T, Bancalari E: Chestwall compliance in full-term and premature infants . Acta Paediatr Scand 1980;69:359-364.Crossref 15. Muller N, Volgyesi G, Bryan MH, et al: The consequences of diaphragmatic muscle fatigue in the newborn infant . J Pediatr 1979;95: 793-797.Crossref 16. Roberts JL, Mathew OP, Thach BT: The efficacy of theophylline in premature infants with mixed and obstructive apnea and apnea associated with pulmonary and neurologic disease . J Pediatr 1982;100:968-970.Crossref 17. Aranda JV, Grondin D, Sasyniuk BI: Pharmacologic considerations in the therapy of neonatal apnea . Pediatr Clin North Am 1981;28: 113-133. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Limitations of Theophylline in the Treatment of Apnea of Prematurity

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Publisher
American Medical Association
Copyright
Copyright © 1985 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1985.02140080037028
Publisher site
See Article on Publisher Site

Abstract

Abstract • Theophylline is commonly used to treat apnea of prematurity. To determine the effectiveness of theophylline with respect to gestational and postnatal age, we conducted a controlled study in 43 premature infants with idiopathic apnea. Three of the 21 treated and eight of the 22 control infants developed respiratory failure. Eight of the 11 infants with respiratory failure had gestational ages of less than 31 weeks and had more than four apneic episodes during the first day of life. In the treated infants without respiratory failure, the number of apneic episodes by 24-hour intervals declined six days earlier than in the control infants. Apnea disappeared, however, at a similar time in both groups. Three treated infants and three control infants had apneic episodes persisting beyond the neonatal period. Patients treated with theophylline did not develop respiratory failure as often as control infants did. However, despite a reduction of apneic episodes, theophylline did not shorten the course of apnea of prematurity. (AJDC 1985;139:567-570) References 1. Peabody JL, Neese AL, Philip AGS, et al: Transcutaneous oxygen monitoring in aminophylline-treated apneic infants . Pediatrics 1978; 62:698-701. 2. Hiatt IM, Hegyi T, Indyk L, et al: Continuous monitoring of PO2 during apnea of prematurity . J Pediatr 1981;98:288-291.Crossref 3. Daily WJR, Klaus M, Meyer HBP: Apnea in premature infants: Monitoring incidence, heart rate changes, and an effect of environmental temperature . Pediatrics 1969;43:510-517. 4. Rigatto H: Apnea and periodic breathing . Semin Perinatol 1977;1:375-381. 5. Cooke RWI, Rolfe P, Howat P: Apparent cerebral blood flow in newborns with respiratory disease . Dev Med Child Neurol 1979;21:154-160.Crossref 6. Kuzemko JA, Paala J: Apneoic attacks in the newborn treated with aminophylline . Arch Dis Child 1973;48:404-406.Crossref 7. Shannon DC, Gotay F, Stein IM, et al: Prevention of apnea and bradycardia in low-birthweight infants . Pediatrics 1975;55:589-594. 8. Uauy R, Shapiro DL, Smith B, et al: Treatment of severe apnea in prematures with orally administered theophylline . Pediatrics 1975;55: 595-598. 9. Bednarek FJ, Roloff DW: Treatment of apnea of prematurity with aminophylline . Pediatrics 1976;58:335-339. 10. Rigatto H: Apnea . Pediatr Clin North Am 1982;29:1105-1106. 11. Kattwinkel J: Neonatal apnea: Pathogenesis and therapy . J Pediatr 1977;90:342-347.Crossref 12. Schulte FJ: Apnea . Clin Perinatol 1977;4: 65-76. 13. Gerhardt T, Bancalari E: Apnea of prematurity: I. Lung function and regulation of breathing . Pediatrics 1984;74:58-62. 14. Gerhardt T, Bancalari E: Chestwall compliance in full-term and premature infants . Acta Paediatr Scand 1980;69:359-364.Crossref 15. Muller N, Volgyesi G, Bryan MH, et al: The consequences of diaphragmatic muscle fatigue in the newborn infant . J Pediatr 1979;95: 793-797.Crossref 16. Roberts JL, Mathew OP, Thach BT: The efficacy of theophylline in premature infants with mixed and obstructive apnea and apnea associated with pulmonary and neurologic disease . J Pediatr 1982;100:968-970.Crossref 17. Aranda JV, Grondin D, Sasyniuk BI: Pharmacologic considerations in the therapy of neonatal apnea . Pediatr Clin North Am 1981;28: 113-133.

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Jun 1, 1985

References

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