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Archives of Disease in Childhood - Fetal and Neonatal Edition 2000;83:F39-F43; doi:10.1136/fn.83.1.F39
Copyright © 2000 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health.
Arch Dis Child Fetal Neonatal Ed 2000;83:F39-F43 ( July )

Metabolic and respiratory effects of theophylline in the preterm infant

Virgilio P Carnielli, Giovanna Verlato, Franca Benini, Katia Rossi, Monica Cavedagni, Marco Filippone, Eugenio Baraldi, Franco Zacchello

Dipartimento di Pediatria, Via Giustiniani 3, 35128 Padova, Italy

Correspondence to: Dr Carnielli email: carnielli{at}child.pedi.unipd.it

Accepted 17 December 1999

BACKGROUND---Methylxanthines are often administered to preterm infants for the treatment of apnoea.
AIMS---To study the effects of theophylline on energy metabolism, physical activity, and lung mechanics in preterm infants.
METHODS---Indirect calorimetry was performed for six hours before and after administration of a bolus of theophylline (5 mg/kg) in 18 preterm infants while physical activity was recorded with a video camera. Lung mechanics measurements were performed at baseline and 12 and 24 hours after theophylline treatment.
RESULTS---Theophylline increased mean (SEM) energy expenditure by 15 (5) kJ/kg/day and augmented carbohydrate utilisation from 6.8 to 8.0 g/kg/day, but fat oxidation was unchanged. After theophylline treatment, preterm infants had faster respiration, lower transcutaneous CO2, and improved static respiratory compliance without increased physical activity.
CONCLUSIONS---A bolus of 5 mg/kg theophylline increased energy expenditure independently of physical activity, increased carbohydrate utilisation, and improved respiratory compliance. The increased energy expenditure could be detrimental to the growth of the preterm infant.


Keywords: theophylline; preterm infant; calorimetry; energy metabolism; lung; apnoea


© 2000 by Archives of Disease in Childhood

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