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CO(2) inhalation as a treatment for apnea of prematurity: a randomized double-blind controlled trial

Ruben E Alvaro1, Mohammad Khalil, Mansour Qurashi

  • 1Department of Pediatrics, University of Manitoba, Winnipeg, Manitoba, Canada. ralvaro@exchange.hsc.mb.ca

The Journal of Pediatrics
|September 13, 2011
PubMed

Insights

Theophylline effectively reduced apnea in premature infants, while inhaled carbon dioxide (CO2) was less effective and led to treatment failures. Theophylline remains the preferred treatment for apnea of prematurity.

Area of Science:

  • Neonatal Medicine
  • Respiratory Physiology
  • Pharmacology

Background:

  • Apnea of prematurity is a common respiratory challenge in preterm infants.
  • Theophylline is a standard treatment, but alternative therapies are being explored.

Purpose of the Study:

  • To compare the efficacy of theophylline with low-concentration inhaled carbon dioxide (CO2) for treating apnea of prematurity.

Main Methods:

  • A prospective, randomized, double-blind controlled trial involving 87 preterm infants.
  • Infants received either theophylline or placebo with inhaled CO2 via nasal prongs for 3 days.

Main Results:

  • Theophylline significantly reduced apnea time compared to baseline and CO2.
  • Inhaled CO2 showed a less pronounced reduction in apnea time.
  • Seven infants in the CO2 group discontinued treatment due to severe apnea, versus none in the theophylline group.

Conclusions:

  • Theophylline is more effective than low-concentration inhaled CO2 for managing apnea of prematurity.
  • Inhaled CO2, as administered in this study, is not a viable alternative to theophylline.
  • Variability in CO2 delivery may have contributed to its reduced efficacy.
Abstract

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