Caffeine versus Aminophylline for Apnea of Prematurity: A Randomized Clinical Trial

Abstract

Background: Apnea of prematurity is often found in preterm neonates with gestational age less than 34-37 weeks or birth weight (BW) less than 1000 grams. The American Academy of Pediatrics defines apnea as a respiratory halt lasting at least 20 seconds, with bradycardia or cyanosis. Methylxanthines reduce the incidence of apnea. The purpose of this study was to compare the effect of caffeine and aminophylline on the incidence of apnea in premature neonates.   

Methods: This randomized clinical trial study was conducted on 80 premature neonates at ShahidSadoughihospital in Yazd. The first group received the initial dose of 5 mg /kg aminophylline diluted in 5% dextrose with a maintenance dose of 2 mg /kg every 8 hours, while the second group received 30mg/kg of caffeine diluted in 5% dextrose with a 24-hour maintenance dose of 10 mg/kg.                                                                                   

Results: The frequency of apnea was less in caffeine group but it was not significantly different between intervention groups (Pvalue=0.121). Although there was a significant difference in respiratory status between the two groups; so in caffeine group, oxyhood was less necessary for neonates (Pvalue=0.012). Using continuous positive airway pressure (CPAP) was significantly less in aminophylline group (Pvalue=0.012).                                    

Conclusion: The frequency of apnea was less in the caffeine group, but there was no significant difference between the two groups (P=0.121). Aminophylline treatment in comparison with caffeine can reduce the need for CPAP in neonates with apnea.