THE ROLE OF CAFFEINE IN NONINVASIVE RESPIRATORY SUPPORT VERSUS AMINOPHYLLINE IN PREMATURITY APNEA

Abstract

Background: Since caffeine and aminophylline serve as both respiratory stimulants to raise minute ventilation and neurological stimulants to promote diaphragm contraction and respiratory muscle function, they are commonly administered as the first-line treatments for apnea in preterm newborns. A combination of two main therapies is used to treat preterm apnea: medication and oxygen supplementation, both of which are essential for healthy bodily functions. Even though aminophylline and caffeine citrate have historically been the main therapies for baby apnea in clinical settings, a comparison of the effectiveness and safety of these medications in the management of apnea has to be done.

Objective: To investigate the potential clinical benefits of giving caffeine and aminophylline to treat apnea of prematurity in varying oxygen (O2) delivery conditions.

Study design: A retrospective study

Place and Duration: This study was conducted in Pediatric Department, lyari General Hospital Shaheed Mohtarma Benazir Bhutto Medical College Lyari Karachi. from October 2022 to October 2023

Methodology: All of the participants in this research were preterm babies with apnea. All of the babies underwent aminophylline or caffeine treatment. The physician could choose either aminophylline or caffeine as a therapy. One group of newborns with apnea were given intravenous (IV) injections of caffeine, beginning with a 20 mg/kg dose and continuing with a regular maintenance dose of 10 mg/kg until the babies reached the 34th week of gestation. Alternatively, other infants were given an IV dosage of aminophylline, commencing at 5 mg/kg, and then a maintenance dose of 2.5 mg/kg twice daily after delivery until the babies reached the 34th week of gestation.

Results: There were a total of 40 preterm babies involved in this research. Out of these 40 preterm babies, 21 were boys and 19 were girls. The birth weight of these babies ranged from 500 to 1250 grams. Our study found a significantly lower incidence of apnea with rates of 61.38% (≤ 29 weeks), 43.03% (30–31 weeks), 18.8% (32–33 weeks), and 2.99% (34–35 weeks). The neonates treated with both medications had comparable rates of ventilator replacement and recurrence of apnea.

Conclusion: Caffeine and aminophylline are both beneficial for reducing apnea episodes and assisting with ventilator weaning in extremely preterm newborns.