Acute hemodynamic effects of methylxanthine therapy in preterm neonates: Effect of variations in subgroups.
Aminophylline
/ therapeutic use
Apnea
/ diagnosis
Caffeine
/ blood
Dose-Response Relationship, Drug
Echocardiography
Female
Gestational Age
Heart Rate
/ drug effects
Humans
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases
/ drug therapy
Male
Treatment Outcome
Ventilator Weaning
/ methods
Xanthines
/ therapeutic use
Apnea of prematurity
appropriate for gestation age
cardiac parameters
prevention of extubation failure
small for gestation age
Journal
Journal of tropical pediatrics
ISSN: 1465-3664
Titre abrégé: J Trop Pediatr
Pays: England
ID NLM: 8010948
Informations de publication
Date de publication:
01 06 2019
01 06 2019
Historique:
pubmed:
8
8
2018
medline:
2
4
2020
entrez:
8
8
2018
Statut:
ppublish
Résumé
Methylxanthines have cardiac stimulant effects. The current study aimed to compare acute hemodynamic changes between caffeine and aminophylline in ≤34 weeks' preterm neonates. The study was performed using information on echocardiography measurements from preterm neonates recruited for apnea of prematurity (75 of 240) and preventing extubation failure (113 of 156) studies. The neonates were randomized either to the caffeine or aminophylline groups. Neonates with no maintenance followed by loading doses with both the methylxanthines (caffeine and aminophylline) and incomplete echocardiography examination were excluded. Cardiac parameters were found to be similar between groups. The heart rate was higher among the aminophylline-treated neonates (p < 0.001) than among the caffeine-treated ones. End-systolic volume was higher among both caffeine- (p < 0.001) and aminophylline-treated neonates (p = 0.001) when compared with pretreatment values. End-diastolic volume was statistically higher in both groups' neonates (p = 0.01). The odds of increase in cardiac output was higher; however, increase in ejection fraction was less in caffeine-treated small-for-gestation-age neonates. Caffeine has similar effects on cardiac parameters as aminophylline; however, caffeine-treated small-for-gestation stratification gave rise to significant cardiac variations.
Sections du résumé
BACKGROUND
Methylxanthines have cardiac stimulant effects. The current study aimed to compare acute hemodynamic changes between caffeine and aminophylline in ≤34 weeks' preterm neonates.
METHODS
The study was performed using information on echocardiography measurements from preterm neonates recruited for apnea of prematurity (75 of 240) and preventing extubation failure (113 of 156) studies. The neonates were randomized either to the caffeine or aminophylline groups. Neonates with no maintenance followed by loading doses with both the methylxanthines (caffeine and aminophylline) and incomplete echocardiography examination were excluded.
RESULTS
Cardiac parameters were found to be similar between groups. The heart rate was higher among the aminophylline-treated neonates (p < 0.001) than among the caffeine-treated ones. End-systolic volume was higher among both caffeine- (p < 0.001) and aminophylline-treated neonates (p = 0.001) when compared with pretreatment values. End-diastolic volume was statistically higher in both groups' neonates (p = 0.01). The odds of increase in cardiac output was higher; however, increase in ejection fraction was less in caffeine-treated small-for-gestation-age neonates.
CONCLUSION
Caffeine has similar effects on cardiac parameters as aminophylline; however, caffeine-treated small-for-gestation stratification gave rise to significant cardiac variations.
Identifiants
pubmed: 30085175
pii: 5061536
doi: 10.1093/tropej/fmy044
doi:
Substances chimiques
Xanthines
0
Aminophylline
27Y3KJK423
methylxanthine
28109-92-4
Caffeine
3G6A5W338E
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
264-272Informations de copyright
© The Author(s) [2018]. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.