Friday March 27, 2009 (pediatric pearl)
Aminophylline prevents apnea during prostaglandin E1 infusion in neonates with ductal dependent cardiac lesion

Apnea is associated with prostaglandin E1 infusion (PGE1) used in the palliation of ductal-dependent congenital heart lesions. It has concomitant dose-dependent side effects, of which respiratory depression has been noted to occur in 12%-18% of neonates. Many of these neonates are started on PGE1 during transport to a tertiary center. There are risks associated with apnea during the transport process and also risks associated with intubation.

Aminophylline is a central respiratory stimulant given as a bolus dose of 6 mg/kg before or during initiation of PGE1, and continued at 2 mg/kg dose every 8 hours for 72 hours was effective for the prevention of apnea and intubation for apnea associated with PGE1 in infants with ductal-dependent congenital heart disease. Infants receiving aminophylline (n = 21/ 42) were less likely to have apnea (2 vs 11) or be intubated for apnea (0 vs 6). No significant side effects of aminophylline were seen.


Reference: click to get abstract

Aminophylline for the Prevention of Apnea During Prostaglandin E1 Infusion - Pediatrics 2003 Jul;112(1 Pt 1):e27-9.