Abstract
Aminophylline (A) is often used to treat apnea of prematurity. To determine response times, optimal length of therapy, effectiveness of A in relation to gestational age (GA) and postnatal age (PA), we conducted a randomized, blinded controlled study in 45 premature infants with recurrent apnea. Infants were divided into 2 groups. Group I (n=23, BW=1395±359g, GA=31±2wks., PA=3.2±2d) received A (mean serum level 8.9mcg/ml) and Group II (n=22, BW=1306±336g, GA=30±2wks., PA=2.3±1.8d). Results: In infants not requiring assisted ventilation (AV): Group I (18/22) had less apnea 24 hours after institution of therapy (p<.025) and apnea ended in 67% of the infants by the 7th day. In 3 infants, apnea was minimally reduced (<25%) during the first 7 d and persisted for 4 weeks despite continued therapy. Group II (14/23) did not show a significant decrease in apnea until 72 hours and only 35% were free of apnea by 7th day. Apnea persisted in 3 infants for 4 weeks. In infants requiring AV: similar numbers in both groups developed respiratory failure. Twelve of the 13 infants needing AV were ≤ 31 GA and had ≥ 4 apneic episodes during the first 24 hours PA. Conclusion: A does not prevent respiratory failure and is not effective in infants ≤ 31 wks. GA with early onset repetitive apnea. Twenty percent of premature infants are refractory to A and can be identified by evaluating their response within the first 7 days of therapy. Prolonged treatment with A is not an effective therapy for apnea of prematurity.
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Sims, M., Rambhatla, S., Yau, G. et al. FACTORS AFFECTING THE EFFICACY OF AMINOPHYLLINE FOR APNEA OF PREMATURITY. Pediatr Res 18 (Suppl 4), 405 (1984). https://doi.org/10.1203/00006450-198404001-01871
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DOI: https://doi.org/10.1203/00006450-198404001-01871