A Randomized Controlled Trial of Theophylline Versus CO2 Inhalation for Treating Apnea of Prematurity

被引:27
作者
Al-Saif, Saif [1 ]
Alvaro, Ruben [1 ]
Manfreda, Juri [2 ]
Kwiatkowski, Kim [1 ]
Cates, Don [1 ]
Qurashi, Mansour [1 ]
Rigatto, Henrique [1 ]
机构
[1] Univ Manitoba, Dept Pediat, Winnipeg, MB R3T 2N2, Canada
[2] Univ Manitoba, Dept Med, Winnipeg, MB, Canada
基金
英国医学研究理事会;
关键词
D O I
10.1016/j.jpeds.2008.04.025
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objective To determine whether inhalation of 0.8% CO2 infants decreases infants decreases the duration and rate of apnea as effectively as or better than theophylline with fewer adverse side effects. Study design A prospective, randomized, control study of 42 preterm infants of gestational age 27 to 32 weeks assigned to receive inhaled CO2 (n = 21) or theophylline (n = 21). The study group had a mean (+/- standard error of the mean) birth weight of 1437 +/- 57 g. gestational age of 29.4 +/- 0.3 weeks, and postnatal age of 43 +/- 4 days. After a control period. 0.8% CO2 or theophylline was given for 2 hours, followed by a recovery period. Results In the CO2 group, apneic time and rate decreased significantly, from 9.4 +/- 1.6 seconds/minute and 94 +/- 1.5) apneic episodes/hour to 3.0 +/- 0.5 seconds/minute and 34 5 apneic episodes/hour. Ill die theophylline group. apneic time and rate decreased significantly, from 8 +/- 1 seconds/minute and 80 8 apneic episodes/hour to 2.5 +/- 0.4 seconds/minute and 28 3 apneic episodes/hour. Cerebral blood flow velocity (CBFV) decreased only during theophylline administration. Conclusions Our findings suggest that inhaled loll, (0.8%) CO2 concentrations in preterm infants is at least as effective as theophylline in decreasing the duration and number of apneic episodes, has fewer side effects. and causes no clianges in CBFV. We speculate that CO2 may be a better treatment for apnea of prematurity than methylxanthines.
引用
收藏
页码:513 / 518
页数:6
相关论文
共 39 条
[11]   CHANGES IN CEREBRAL BLOOD-FLOW DURING HYPERVENTILATION AND CO2-BREATHING MEASURED TRANSCUTANEOUSLY IN HUMANS BY A BIDIRECTIONAL, PULSED, ULTRASOUND DOPPLER BLOOD VELOCITY-METER [J].
HAUGE, A ;
THORESEN, M ;
WALLOE, L .
ACTA PHYSIOLOGICA SCANDINAVICA, 1980, 110 (02) :167-173
[12]  
HENDELES L, 1983, PHARMACOTHERAPY, V3, P2
[13]  
HENDERSONSMART DJ, 2001, COCHRANE DB SYST REV, V4
[14]  
HENDERSONSMART DJ, 1998, COCHRANE DATABASE SY, V4
[15]   Adenosine modulates inspiratory neurons and the respiratory pattern in the brainstem of neonatal rats [J].
Herlenius, E ;
Lagercrantz, H ;
Yamamoto, Y .
PEDIATRIC RESEARCH, 1997, 42 (01) :46-53
[16]   Caffeine impairs cerebral and intestinal blood flow velocity in preterm infants [J].
Hoecker, C ;
Nelle, M ;
Poeschl, J ;
Beedgen, B ;
Linderkamp, O .
PEDIATRICS, 2002, 109 (05) :784-787
[17]  
HOWELL J, 1981, SEMIN PERINATOL, V5, P359
[18]   CEREBRAL-PALSY IN VERY-LOW-BIRTH-WEIGHT INFANTS SURVIVING TO 2 YEARS WITH MODERN PERINATAL INTENSIVE-CARE [J].
KITCHEN, WH ;
DOYLE, LW ;
FORD, GW ;
RICKARDS, AL ;
LISSENDEN, JV ;
RYAN, MM .
AMERICAN JOURNAL OF PERINATOLOGY, 1987, 4 (01) :29-35
[19]   IMPROVED UNDERSTANDING OF RESPIRATORY CONTROL IMPLICATIONS FOR THE TREATMENT OF APNEA [J].
LAGERCRANTZ, H .
EUROPEAN JOURNAL OF PEDIATRICS, 1995, 154 (08) :S10-S12
[20]   Aggressiveness, hypoalgesia and high blood pressure in mice lacking the adenosine A(2a) receptor [J].
Ledent, C ;
Vaugeois, JM ;
Schiffmann, SN ;
Pedrazzini, T ;
ElYacoubi, M ;
Vanderhaeghen, JJ ;
Costentin, J ;
Heath, JK ;
Vassart, G ;
Parmentier, M .
NATURE, 1997, 388 (6643) :674-678