title: Prophylactic theophylline infusion for prevention of apnea of prematurity.
abstract: To assess if there was any advantage in the prophylactic use of theophylline to prevent apnea in preterms, we treated 56 preterms (Group A) < 34 weeks gestation with theophylline infusion and compared these with 25 age and weight matched preterms (Group B) who received no therapy. Aminophylline (25 mg/ml) was infused from admission in all neonates (group A) at rates ranging 0.2 to 0.38 mg/kg/h and blood levels estimated on an Abbots TDX analyser by Fluorescence Polarization Immunoassay, after 5 days infusion. All neonates (Groups A + B) were monitored on a Corometric 505 neonatal monitor. In Group A, 1/48 developed primary apnea while in Group B, 4-21 had primary apnea (p < 0.05). Serum theophylline ranged from 2.3 to 39.5 micrograms/ml with a mean of 12.7 micrograms/ml. The mean serum level of theophylline in 4 cases who exhibited clinical evidences of toxicity was 30.1 micrograms/ml. A statistically significant difference (p < 0.05) was noted in birth weight and serum level inspite of similar infusion rates of theophylline. A linear correlation r = 0.65 was noted between serum level and infusion rate. Multivariate regression analysis, between birth weight and gestational age to serum level, showed a linear correlationship only between birth weight and serum level (r = 0.45).
authors.affiliation: Division of Neonatology, B.J. Wadia Hospital for Children, Nanavati Hospital, Bombay.
authors.forename: R H
authors.initials: RH
authors.lastname: Merchant
authors.forename: V S
authors.initials: VS
authors.lastname: Sakhalkar
authors.forename: T F
authors.initials: TF
authors.lastname: Ashavaid
mesh_terms: D000628:Aminophylline / Q000097:blood / Q000627:therapeutic use; D001049:Apnea / Q000097:blood / Q000517:prevention & control*; D001724:Birth Weight; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000097:blood / Q000517:prevention & control*; D007262:Infusions, Intravenous; D011446:Prospective Studies; D013806:Theophylline / Q000097:blood / Q000627:therapeutic use*
chemical_list: D000628:Aminophylline; D013806:Theophylline