Caffeine versus Aminophylline for Apnea of Prematurity: A Randomized Clinical Trial

Document Type : Original Article

Authors
Mohamad Hosein Lookzadeh 1 , 2
Elaha Jafari Abeshoori 2
Mahmood Noorishadkam 1 , 2
Seyed Reza Mirjalili 1 , 2
Hamid Reza Mohammadi 3
Fatemeh Emambakhshsani 2
1 Department of Pediatrics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2 Mother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
3 Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
10.18502/wjpn.v2i2.4338
Abstract
 
Background: Apnea of prematurity is often found in preterm neonates with gestational age less than 34-37 weeks or birth weight (BW) less than 1000 grams. The American Academy of Pediatrics defines apnea as a respiratory halt lasting at least 20 seconds, with bradycardia or cyanosis. Methylxanthines reduce the incidence of apnea. The purpose of this study was to compare the effect of caffeine and aminophylline on the incidence of the apnea in premature infants.
Methods: This randomized clinical trial study was conducted on 80 premature neonates at Shahid Sadoughi hospital in Yazd. The first group received the initial dose of 5 mg/kg aminophylline diluted in 5% dextrose with a maintenance dose of 2 mg/kg every 8 hours, while the second group received 30 mg/kg of caffeine diluted in 5% dextrose with a 24-hour maintenance dose of 10 mg/kg.
Results: There was no significant difference infrequency of apnea between the two groups (P = 0.121). However there was a significant difference in respiratory status between the two groups so that in caffeine group, oxyhood was less necessary for neonates (P = 0.012) and using continuous positive airway pressure (CPAP) was significantly less in aminophylline group (P = 0.012).
Conclusion: Our study showed that the frequency of apnea was less in the caffeine group, but there was no significant difference between the two groups. Aminophylline treatment in comparison with caffeine can reduce the need for CPAP in neonates with apnea.
Keywords
Aminophylline
Caffeine
Apnea
Prematurity
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Journal of Integrated Maternal and Pediatric Care
Volume 2, Issue 2
October 2019
Pages 47-53

  • Receive Date 03 October 2020