Factors affecting the efficacy and safety of aminophylline in treatment of apnea of prematurity in neonatal intensive care unit

Background: The factors affecting the safety and efficacy of aminophylline use in the treatment of apnea of prematurity (AOP) in the neonatal intensive care unit (NICU) are not clear. In this study, we aimed to evaluate the potential factors affecting the efficacy and safety of aminophylline in AOP...

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Main Authors: Chaohui Ye, Caiyun Miao, Li Yu, Zhuoya Dong, Jie Zhang, Yingying Mao, Xiaodong Lu, Qin Lyu
Format: Article
Language:English
Published: Elsevier 2019-02-01
Series:Pediatrics and Neonatology
Online Access:http://www.sciencedirect.com/science/article/pii/S1875957217308057
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author Chaohui Ye
Caiyun Miao
Li Yu
Zhuoya Dong
Jie Zhang
Yingying Mao
Xiaodong Lu
Qin Lyu
author_facet Chaohui Ye
Caiyun Miao
Li Yu
Zhuoya Dong
Jie Zhang
Yingying Mao
Xiaodong Lu
Qin Lyu
author_sort Chaohui Ye
collection DOAJ
description Background: The factors affecting the safety and efficacy of aminophylline use in the treatment of apnea of prematurity (AOP) in the neonatal intensive care unit (NICU) are not clear. In this study, we aimed to evaluate the potential factors affecting the efficacy and safety of aminophylline in AOP treatment at standard doses and to determine appropriate patients for this therapy. Methods: Over a 3-year period (January 2012 to December 2014), the medical records of 206 preterm infants with apnea who were admitted to the NICU of our hospital to receive aminophylline infusions were retrospectively reviewed. These infants were subjected to routine theophylline monitoring by reversed-phase high performance liquid chromatography. The primary outcome measures were the efficacy of aminophylline treatment and adverse reactions observed upon administration. Results: One-hundred and twenty-seven (61.65%) infants were considered to have undergone effective therapy and classified accordingly. Gestational age, body weight at the initiation of aminophylline, and serum theophylline concentration were identified as protective factors of therapeutic efficacy. Receiver operating characteristic (ROC) analysis indicated cutoff values of 30.36 weeks for gestational age and 1.69 kg for body weight at initiation of aminophylline administration for ensuring high efficacy of aminophylline for AOP. Fifty-three (25.73%) infants had adverse reactions. Birth weight and serum concentration of theophylline were associated with an increased risk of adverse reactions, with odds ratios of 0.167 and 1.346, respectively. The ROC curves indicated a birth weight cutoff value of 1.48 kg. Conclusion: Infants with apnea and gestational age >30.36 weeks, body weight at initiation of aminophylline treatment above 1.69 kg, and birth weight >1.48 kg are suitable for treatment with aminophylline. Monitoring of serum theophylline concentration should be implemented in the absence of clinical response or in case of suspected adverse reactions. Key Words: aminophylline, apnea of prematurity, concentration, efficacy, factor
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spelling doaj-art-25135e39fa68402ca9cb244df8683a8f2025-08-20T02:54:51ZengElsevierPediatrics and Neonatology1875-95722019-02-01601434910.1016/j.pedneo.2018.03.008Factors affecting the efficacy and safety of aminophylline in treatment of apnea of prematurity in neonatal intensive care unitChaohui Ye0Caiyun Miao1Li Yu2Zhuoya Dong3Jie Zhang4Yingying Mao5Xiaodong Lu6Qin Lyu7Department of Pharmacy, Ningbo Women & Children Hospital, Ningbo 315012, Zhejiang, ChinaDepartment of Pharmacy, Ningbo Women & Children Hospital, Ningbo 315012, Zhejiang, ChinaDepartment of Pharmacy, The Affiliated Hospital of Medical School of Ningbo University, Ningbo 315020, Zhejiang, ChinaDepartment of Neonatal Intensive Care Unit, Ningbo Women & Children Hospital, Ningbo 315012, Zhejiang, ChinaDepartment of Pharmacy, Ningbo Women & Children Hospital, Ningbo 315012, Zhejiang, ChinaDepartment of Pharmacy, Ningbo Women & Children Hospital, Ningbo 315012, Zhejiang, ChinaDepartment of Pharmacy, Ningbo Women & Children Hospital, Ningbo 315012, Zhejiang, ChinaDepartment of Neonatal Intensive Care Unit, Ningbo Women & Children Hospital, Ningbo 315012, Zhejiang, China; Corresponding author. Fax: +86 574 87116761.Background: The factors affecting the safety and efficacy of aminophylline use in the treatment of apnea of prematurity (AOP) in the neonatal intensive care unit (NICU) are not clear. In this study, we aimed to evaluate the potential factors affecting the efficacy and safety of aminophylline in AOP treatment at standard doses and to determine appropriate patients for this therapy. Methods: Over a 3-year period (January 2012 to December 2014), the medical records of 206 preterm infants with apnea who were admitted to the NICU of our hospital to receive aminophylline infusions were retrospectively reviewed. These infants were subjected to routine theophylline monitoring by reversed-phase high performance liquid chromatography. The primary outcome measures were the efficacy of aminophylline treatment and adverse reactions observed upon administration. Results: One-hundred and twenty-seven (61.65%) infants were considered to have undergone effective therapy and classified accordingly. Gestational age, body weight at the initiation of aminophylline, and serum theophylline concentration were identified as protective factors of therapeutic efficacy. Receiver operating characteristic (ROC) analysis indicated cutoff values of 30.36 weeks for gestational age and 1.69 kg for body weight at initiation of aminophylline administration for ensuring high efficacy of aminophylline for AOP. Fifty-three (25.73%) infants had adverse reactions. Birth weight and serum concentration of theophylline were associated with an increased risk of adverse reactions, with odds ratios of 0.167 and 1.346, respectively. The ROC curves indicated a birth weight cutoff value of 1.48 kg. Conclusion: Infants with apnea and gestational age >30.36 weeks, body weight at initiation of aminophylline treatment above 1.69 kg, and birth weight >1.48 kg are suitable for treatment with aminophylline. Monitoring of serum theophylline concentration should be implemented in the absence of clinical response or in case of suspected adverse reactions. Key Words: aminophylline, apnea of prematurity, concentration, efficacy, factorhttp://www.sciencedirect.com/science/article/pii/S1875957217308057
spellingShingle Chaohui Ye
Caiyun Miao
Li Yu
Zhuoya Dong
Jie Zhang
Yingying Mao
Xiaodong Lu
Qin Lyu
Factors affecting the efficacy and safety of aminophylline in treatment of apnea of prematurity in neonatal intensive care unit
Pediatrics and Neonatology
title Factors affecting the efficacy and safety of aminophylline in treatment of apnea of prematurity in neonatal intensive care unit
title_full Factors affecting the efficacy and safety of aminophylline in treatment of apnea of prematurity in neonatal intensive care unit
title_fullStr Factors affecting the efficacy and safety of aminophylline in treatment of apnea of prematurity in neonatal intensive care unit
title_full_unstemmed Factors affecting the efficacy and safety of aminophylline in treatment of apnea of prematurity in neonatal intensive care unit
title_short Factors affecting the efficacy and safety of aminophylline in treatment of apnea of prematurity in neonatal intensive care unit
title_sort factors affecting the efficacy and safety of aminophylline in treatment of apnea of prematurity in neonatal intensive care unit
url http://www.sciencedirect.com/science/article/pii/S1875957217308057
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