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. 2016 Jul 7;11(7):e0157198.
doi: 10.1371/journal.pone.0157198. eCollection 2016.

Predictive Factors for Efficacy and Safety of Prophylactic Theophylline for Extubation in Infants with Apnea of Prematurity

Tomoko Kondo  1   2 , Yuki Kondo  1 , Yuji Orita  3 , Fumi Mitarai  1 , Yoichi Ishitsuka  1 , Mitsuru Irikura  4 , Yoshihiro Shimodozono  5 , Tsutomu Douchi  3 , Yasuo Takeda  2 , Tetsumi Irie  1   6
Affiliations

Predictive Factors for Efficacy and Safety of Prophylactic Theophylline for Extubation in Infants with Apnea of Prematurity

Tomoko Kondo et al. PLoS One. .

Abstract

Purpose: This study aimed to evaluate predictive factors involved in efficacy and safety in Japanese infants who received theophylline therapy to prevent apnea of prematurity (AOP) after weaning from mechanical ventilation.

Methods: We retrospectively reviewed the medical records of infants who were administered intravenous aminophylline (theophylline ethylenediamine) for AOP at the neonatal intensive care unit, Kagoshima University Hospital, Japan, between January 2009 and June 2013.

Results: A total of 100 infants were evaluated as two separate groups in terms of efficacy and safety of theophylline. Sixty-seven (67.0%) infants had effective theophylline therapy. Multivariate logistic regression analysis showed that gestational age at birth was significant, with an odds ratio of 0.59 (p < 0.001). Receiver operating characteristic analysis showed that the cut-off value was 31.1 weeks old for predicting the efficacy of theophylline (specificity, 66.7%; sensitivity, 86.6%; p < 0.001; area under the curve, 0.750; 95% confidence interval, 0.45-0.74). Adverse reactions were identified in 21 (21.0%) infants. Multivariate logistic regression analysis showed that the number of days of theophylline administration from birth was associated with an increased risk of adverse reactions after theophylline administration (p = 0.01).

Conclusions: Physicians need to be aware of the possibility that theophylline fails to produce therapeutic effects for extubation in infants aged less than 31.1 weeks old, and adverse reactions can easily develop when theophylline is administered soon after birth.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Basic protocol of theophylline administration when weaning from mechanical ventilation.
Fig 2
Fig 2. Receiver operating characteristic curve for predicting efficacy of theophylline with gestational age.
See this image and copyright information in PMC

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