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An evaluation of theophylline for idiopathic apnea of infancy
Insights
Theophylline significantly reduced central apnea and periodic breathing in infants. This treatment improved breathing patterns during sleep but did not affect obstructive apneas or bradycardia.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Pharmacology
Background:
- Infantile apnea and periodic breathing are significant concerns in neonates.
- Theophylline is a methylxanthine drug with respiratory stimulant properties.
- Understanding the efficacy of theophylline in treating these conditions is crucial for infant respiratory care.
Purpose of the Study:
- To evaluate the effect of oral theophylline on central apnea and periodic breathing in infants.
- To assess changes in respiratory parameters and oxygen saturation during sleep following theophylline administration.
Main Methods:
- A study involving 19 infants diagnosed with infantile apnea and periodic breathing.
- Continuous monitoring of electro-oculograms, end-tidal CO2, heart rate, impedance respirations, and transcutaneous pO2 (tcpO2) during naps.
- Comparison of respiratory data before and after 7 days of theophylline therapy (mean dose 2.3 mg/kg q. 6 h).
Main Results:
- Theophylline therapy significantly reduced central apnea attack rates in both REM and non-REM sleep.
- A decrease in periodic breathing and time spent with low transcutaneous pO2 (40-50 mm Hg) during non-REM sleep was observed.
- No significant reduction in obstructive apneas, bradycardias with apnea, or the magnitude of tcpO2 falls was noted.
Conclusions:
- Theophylline effectively reduces central apnea and periodic breathing in infants.
- Further research is needed to determine the long-term effects and safety of theophylline for these conditions.
Abstract:
19 infants admitted with a diagnosis of infantile apnea who were found to have periodic breathing were given oral theophylline to determine its effect. They were studied at a mean age of 7.1 weeks (1-16.4 week). Each infant was studied during two naps, immediately before and 7 days following the institution of theophylline therapy, which averaged 2.8 h in duration during which electro-oculograms, end-tidal CO2, heart rate, impedance respirations, and transcutaneous pO2 (tcpO2) were continuously monitored. Theophylline therapy (mean dose 2.3 mg/kg q. 6 h) was associated with a significant reduction of apnea attack rates in both REM and non-REM sleep. Periodic breathing and the number of minutes per hour of sleep during which the TC pO2 was between 40-50 mm Hg in non-REM sleep also decreased. There was no significant reduction in the number of obstructive apneas, the number of bradycardias with apnea, nor the largest single fall in tcpO2. Theophylline can significantly reduce central apnea and periodicity in the age group studied, but the long-term effects of such therapy require further assessment.