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Drug Safety
Published in: Drug Safety 5/2000

01-11-2000 | Review Article

Risks and Benefits of Therapies for Apnoea in Premature Infants

Authors: Dr Jean-Michel Hascoet, Isabelle Hamon, Marie-Jeanne Boutroy

Published in: Drug Safety | Issue 5/2000

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Abstract

Apnoea in infants can result from a wide range of causes, and requires thorough evaluation before deciding on appropriate treatment. Continuous monitoring of premature infants with apnoea is mandatory in order to define the pathophysiology and type of apnoea; selection of treatment involves careful assessment of aetiology, as well as efficacy and tolerability in each individual case. The objective of treatment is to prevent the deleterious consequences of apnoeas that last >20 seconds and/or are associated with bradycardia, cyanosis or pallor, and occur more often than once an hour over a 12-hour period.
Apnoea management involves both pharmacological and nonpharmacological treatment. We suggest methylxanthines as first-line therapy for idiopathic apnoeas; evidence suggests that caffeine is better tolerated and as efficacious as theophylline (since it is particularly efficacious against the ‘central’ component of idiopathic apnoea of prematurity). If treatment fails, additional measures such as doxapram may be appropriate when hypoventilation is present, or nasal continuous positive airway pressure when upper airway instability or obstructive apnoeas are predominant. Apnoea prophylaxis is an additional reason to advocate prenatal maturation with betamethasone. Weaning from treatment is attempted 4 to 5 days after complete resolution of apnoea, beginning with the last treatment introduced. Monitoring should be maintained for 4 to 5 days to detect any relapse of recurrent and severe apnoeas, which would lead to the resumption of the most recently withdrawn treatment.
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Metadata
Title
Risks and Benefits of Therapies for Apnoea in Premature Infants
Authors
Dr Jean-Michel Hascoet
Isabelle Hamon
Marie-Jeanne Boutroy
Publication date
01-11-2000
Publisher
Springer International Publishing
Published in
Drug Safety / Issue 5/2000
Print ISSN: 0114-5916
Electronic ISSN: 1179-1942
DOI
https://doi.org/10.2165/00002018-200023050-00002

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