Prophylactic aminophylline

[thabit]

Best wishes for all...
We somtimes use propylactic aminophylline in apnea of prematurity(after exclusion of pathological causes for apnea)
any has experience about this topic
thanks

[Stefan Johansson]

Hi!
We mainly use caffeine, 10 mg/kg as a loading dose, and then 2-3 (-5) mg/kg/d as maintenance.
Here's a really good reference by Schmidt et al in NEJM about caffeine and apneas in preterm infants, available in free full-text:
http://content.nejm.org/cgi/content/full/357/19/1893

[wackdi]

Hi!

In the Cochrane review Caffeine had the same effect i treating apneas but had several advantages: Adverse effects like feeding intolerance and tachycardia were lower in the Caffeine groups.

http://www.cochrane.org/reviews/en/ab000273.html

So we are using only Caffeine(citrate) in our unit.

Best wishes

Dirk

[selvanr4]

Hello,
can we use prophylactic aminophylline in babies born before 34 weeks.? Many of them can have apnoea around 5 th to 7 th day.It saves investment on apnoea monitor! can it be continued till 37 weeks?
thanks
r.selvan

[wackdi]

Hi!
In the study mentioned by Stefan they used Caffeine both as a treatment and prophylactic drug.
We do so too. Especially if the baby is born less than 28-30 weeks of gestational age we often use it prophylactic. We usually wean the babies from the drug by not adapting the dose to the increasing weight and try to stop it with about 34-35 GA.
While on Caffeine-prophylaxes/therapy we have them on SaO2 monitoring for dosing reasons.

Many greetings from Sweden

Dirk