Title: Comparison of Aminophylline Alone and in Combination with Doxapram For Cessation of Apnea of Prematuriy
Authors: Dr Suresh Kumar Verma (MD Pediatrics), Dr Kapil Kumar Raheja (DNB Pediatrics, FNNF), Dr Vishnu Kumar Goyal (MD Pediatrics), Dr Kirti Sachdev (MD Medicine), Dr Harish Mourya (MD Pediatrics), Dr Jagdish Chand Dabi (MD Pediatrics)
DOI: https://dx.doi.org/10.18535/jmscr/v5i6.55
Abstract
Background: Apnea of Prematurity remains exceedingly significant clinical problem of premature neonates, associated with significant morbidity and mortality in neonatal intensive care which may be treated with noninvasive respiratory therapy and methyl xanthenes. Aminophylline a freely available methyl xanthenes used alone in apnea of prematurity and given in conjunction with Doxapram in apnea not responding to tactile stimulus. The short term outcomes in term of their efficacy and safety were evaluated and compared in Neonatal intensive care.
Methods: We enrolled total 52 admitted newborns <32 weeks of gestational age with tactile stimulus refractory apnea of prematurity and divided into two equal groups by random blinded slips. One group was given aminophylline as a monotherapy and half received doxapram in a continuous intravenous infusion in combination with aminophylline. All the neonates in study were closely monitored for the recurrence of apnea up to 7 days and for the toxicity of the drug.
Results: Mean birth weight and gestational age of enrolled babies was 1.322+0.122Kg and mean gestational age of babies treated with Aminophylline was 31.11+0.03 weeks while 30.60+0.42 weeks in the combination group. The mean age of the base line apnea was 70.76 hrs in the aminophylline group whereas 68.32 hrs in the combination group. Out of the total 76.92% neonates in Aminophylline group and 80.80% in combination group neonates depicted complete cessation of apnea episodes and remained apnea free.
Conclusions: The combination of Doxapram & Aminophylline proved better then Aminophylline alone during initial hours of drug therapy in reducing the recurrence and need of intubation without any significant short term adverse effects. However until efficacy and safety are confirmed in more prospective trials, combination of Doxapram with Aminophylline should be used with caution.
Keywords: Aminophylline, Doxapram, Apnea of prematurity,Cessation of breath, Newborn.
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