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.
AIMSTo study the
effects of theophylline on energy metabolism, physical activity, and
lung mechanics in preterm infants.
METHODSIndirect
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.
RESULTSTheophylline
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.
CONCLUSIONSA 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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