Acute hemodynamic effects of methylxanthine therapy in preterm neonates: Effect of variations in subgroups

Shivakumar, M and Nayak, Krishnananda and Lewis, Leslie and Kamath, Asha and Jayashree, P (2019) Acute hemodynamic effects of methylxanthine therapy in preterm neonates: Effect of variations in subgroups. Journal of Tropical Pediatrics, 65 (3). pp. 264-272. ISSN 0142-6338

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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. Endsystolic volume was higher among both caffeine- (p<0.001) and aminophylline-treated neonates (p¼0.001) when compared with pretreatment values. End-diastolic volume was statistically higher in both groups’ neonates (p¼0.01). 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, caffeinetreated small-for-gestation stratification gave rise to significant cardiac variations.

Item Type: Article
Uncontrolled Keywords: Apnea of prematurity; appropriate for gestation age; cardiac parameters; prevention of extubation failure; small for gestation age.
Subjects: Allied Health > MCOAHS Manipal > Cardiology
Departments at MU > Statistics
Medicine > KMC Manipal > Paediatrics
Depositing User: KMC Library
Date Deposited: 25 Jun 2019 11:32
Last Modified: 25 Jun 2019 11:32

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