A Randomized Controlled Trial of Theophylline Versus CO2 Inhalation for Treating Apnea of Prematurity

Objective To determine whether inhalation of 0.8% CO2 infants decreases infants decreases the duration and rate of apnea as effectively as or better than theophylline with fewer adverse side effects. Study design A prospective, randomized, control study of 42 preterm infants of gestational age 27 to 32 weeks assigned to receive inhaled CO2 (n = 21) or theophylline (n = 21). The study group had a mean (+/- standard error of the mean) birth weight of 1437 +/- 57 g. gestational age of 29.4 +/- 0.3 weeks, and postnatal age of 43 +/- 4 days. After a control period. 0.8% CO2 or theophylline was given for 2 hours, followed by a recovery period. Results In the CO2 group, apneic time and rate decreased significantly, from 9.4 +/- 1.6 seconds/minute and 94 +/- 1.5) apneic episodes/hour to 3.0 +/- 0.5 seconds/minute and 34 5 apneic episodes/hour. Ill die theophylline group. apneic time and rate decreased significantly, from 8 +/- 1 seconds/minute and 80 8 apneic episodes/hour to 2.5 +/- 0.4 seconds/minute and 28 3 apneic episodes/hour. Cerebral blood flow velocity (CBFV) decreased only during theophylline administration. Conclusions Our findings suggest that inhaled loll, (0.8%) CO2 concentrations in preterm infants is at least as effective as theophylline in decreasing the duration and number of apneic episodes, has fewer side effects. and causes no clianges in CBFV. We speculate that CO2 may be a better treatment for apnea of prematurity than methylxanthines.