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Aminophylline versus caffeine citrate for apnea and bradycardia prophylaxis in premature neonates
P B Larsen1, L Brendstrup, L Skov
1Department of Neonatology, National University Hospital, Rigshospitalet, Copenhagen, Denmark.
Insights
Caffeine citrate and aminophylline equally prevent apnea and bradycardia in premature neonates. Caffeine citrate showed a better safety profile, making it the preferred choice for prophylaxis in preterm infants.
Area of Science:
- Neonatal Medicine
- Pharmacology
- Pediatrics
Background:
- Apnea and bradycardia are common in premature neonates.
- Aminophylline and caffeine citrate are used for prophylaxis.
- Comparing their efficacy and safety is crucial.
Purpose of the Study:
- To compare the efficacy and adverse effects of aminophylline and caffeine citrate.
- To determine the optimal drug for apnea and bradycardia prophylaxis in premature infants.
Main Methods:
- A randomized controlled trial involving 180 premature neonates.
- Participants received either aminophylline (n=98) or caffeine citrate (n=82) for 10 days.
- Efficacy and adverse effects were monitored.
Main Results:
- Both drugs were equally effective in preventing apnea and bradycardia.
- Caffeine citrate group showed a lower median heart rate on day 3.
- Fewer neonates in the caffeine citrate group experienced tachycardia and had less gastric aspirate.
Conclusions:
- Caffeine citrate is the preferred drug for preventing apnea and bradycardia in premature neonates.
- It offers a potentially better safety profile compared to aminophylline.
- Recommended for infants with gestational age <= 33 weeks.
Abstract:
We investigated the efficacy and adverse effects of aminophylline and caffeine citrate in 180 premature neonates for 10 days and nights. Aminophylline (n = 98) and caffeine citrate (n = 82) were equally effective in preventing apnea and bradycardia. The caffeine citrate group had a lower median heart rate on day 3, fewer neonates with tachycardia and a smaller amount of gastric aspirate on day 7. The need for mononasal continuous positive airway pressure and respirator therapy was similar in both groups. We conclude that caffeine citrate is the drug of choice for apnea and bradycardia prophylaxis in premature neonates with a gestational age < or = 33 full weeks.