The effect of theophylline on apnoea and hypoxaemic episodes in the premature neonate during the 1st 3 days after birth

Summary

Although the effect of theophylline on apnoea is well documented, its influence on hypoxaemic episodes in premature neonates is less well known. To investigate the influence of the drug on both parameters, 37 apnoeic neonates were monitored before and after theophylline treatment. Incidents and densities of pathological apnoea (cessation of nasal airflow ≥ 20 seconds) were recorded. A fall of ≥ 10% for >10 seconds in peripheral oxygen saturation was classified as a hypoxaemic episode. Ethical constraints precluded the inclusion of a control group. Each infant served as its own control. Theophylline serum concentrations were 5.6 (3.4), 8 (7.1) and 8 (5.3) mg/l on days 1, 2 and 3, respectively. The apnoea incidents and densities decreased significantly (p = 0.0001) from baseline on all 3 days. The total number of hypoxaemic episodes, as well as those not associated with pathological apnoea, decreased, though not significantly. However, those hypoxaemic episodes associated with pathological apnoea and a fall in pulse rate of ≥ 20% decreased significantly from baseline on day 2 only. Throughout the study period, over 80% of hypoxaemic episodes were not associated with apnoea. It is concluded that in the doses used, theophylline was more effective in reducing apnoea than hypoxaemic episodes in premature neonates.