Neonatal apnea, xanthines, and necrotizing enterocolitis

Abstract

This study evaluates the relationship of xanthine treatment of premature apnea and NEC in a bowel ischemia model. The superior mesenteric artery was occluded for 1.0 minute in 82 wheanling rats. Group I (n = 41) were untreated controls. Group II (n = 21) received aminophylline (AMPH) 40 mg/kg I.P., 4 hr and immediately prior to clamping. Animals were evaluated for bowel infarction, perforation, and mortality at 7 days. In 20 additional rats (10 per group) bowel was evaluated by scanning electron microscopy (EM) at timed intervals (5 and 30 min). Ischemic bowel occurred in 25 of 41 (60%) controls (18 (43%) with necrosis; 7 (17%) with perforations) and 19 of 21 (90%) rats with AMPH (15 (70%) had necrosis; 4 (19%) perforations). Mortality was 60% (controls) and 90% (AMPH) respectively (p less than .05). On EM, AMPH enhanced bacterial overgrowth however actual mucosal damage appeared similar. Following ischemia, AMPH has an adverse effect on the bowel. Use of AMPH in prematures at risk for NEC is questioned.