Respiratory diseases are major causes of morbidity and mortality in premature neonates.
Theophylline has been utilized as an adjunct in facilitating
ventilator weaning and in the management of
apnea with or without
bradycardia. Patient characteristics associated with improved outcome from
theophylline have not been determined. The purpose of this study was to evaluate parameters associated with improved outcome in neonates with
respiratory diseases receiving
theophylline. The study population consisted of premature neonates that were studied retrospectively. Criteria for entry into the study were (1) less than 40 weeks gestation, (2) a diagnosis of
respiratory distress syndrome (RDS),
apnea of prematurity,
hyaline membrane disease (HMD), or
bronchopulmonary dysplasia (BPD), (3) dependence on intermittent mandatory ventilation, (4) failure to wean from the
ventilator 24 h or more before the study, or (5) receiving
theophylline. In this study, we found no correlations between time to wean from the
ventilator and postnatal age at the time
theophylline was initiated, 5-min APGAR score, and final
theophylline serum concentration before complete weaning from the
ventilator. However, there were significant negative correlations between
birthweight and gestational age with respect to time to wean from the
ventilator. The average
theophylline serum concentration before weaning from the
ventilator for this population of neonates was approximately 5-10 micrograms/ml, indicating that
theophylline is not beneficial as an aid to
ventilator weaning at serum concentrations < 10 micrograms/ml.