Cardiac output changes secondary to theophylline therapy in preterm infants |
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| Authors: | F J Walther M E Sims B Siassi P Y Wu |
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| Affiliation: | 1. Monash Newborn, Monash Children''s Hospital, Monash Health, Monash University, Melbourne, Australia;2. Department of Paediatrics, Monash University, Melbourne, Australia;1. Department of Pediatrics, University of California San Francisco, San Francisco, CA;2. Department of Pediatrics, University of Texas, Houston, TX;3. Department of Pediatrics, Case Western Reserve University, Cleveland, OH;4. University of California San Francisco School of Medicine, San Francisco, CA;5. Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA;6. Department of Pediatrics, Benioff Children''s Hospital Oakland, Oakland, CA;7. Department of Pediatrics, Children''s Mercy Hospital, Kansas City, MO;8. Department of Pediatrics, Children''s Hospital and Clinics of Minnesota, St Paul and Minneapolis, MN;9. Department of Pediatrics, Children''s National Medical Center, Washington, DC;10. Department of Pediatrics, Medical University of South Carolina, Charleston, SC;11. Department of Pediatrics, University of Minnesota, Minneapolis, MN;12. Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR;13. Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN;14. Department of Pediatrics, University of Florida College of Medicine, Jacksonville, FL;15. Department of Pediatrics, University of Washington, Seattle, WA;16. Department of Pediatrics, All Children''s Hospital, St. Petersburg, FL;17. Department of Pediatrics, Wake Forest School of Medicine/Forsyth Medical Center, Winston-Salem, NC;18. Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL;19. Department of Pediatrics, Florida Hospital for Children, Orlando, FL;1. Centre for Nutrition and Bowel Disease, Department of Gastroenterology, Aalborg University Hospital, Aalborg, Denmark;2. Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark;3. Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark;4. Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Faculty of Health, Aalborg University, Aalborg, Denmark |
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| Abstract: | The cardiovascular effects of theophylline were studied in 11 clinically stable preterm infants. Theophylline was given as aminophylline using a loading dose of 6.8 mg/kg and a maintenance dose of 2 mg/kg every 8 hours intravenously. Cardiac output, stroke volume, and heart rate were measured using a combination of pulsed Doppler ultrasound and M-mode echocardiography. Compared with day 0, an increase was found in both cardiac output (P less than 0.01) and stroke volume (P less than 0.02) on days 1, 2, and 3. By day 7, stroke volume was comparable to pretreatment values, whereas cardiac output was still increased. Heart rate was augmented significantly (P less than 0.01) throughout the treatment period. Mean arterial blood pressure did not change. All but one of the neonates had serum theophylline concentrations between 6 and 13 mg/L. We conclude that both inotropic and chronotropic effects are evident during the first days of theophylline therapy. The metabolic cost of the increased cardiac output in the preterm infant with theophylline therapy deserves further attention. |
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