Use of caffeine in infants unresponsive to theophylline in apnea of prematurity

Eleven premature infants with severe apnea unresponsive to therapeutic theophylline levels were studied to determine if caffeine is an effective treatment in such cases. Apnea was documented and quantitated with thermistor-pneumocardiograms measuring heart rate, thoracic impedance, and nasal air flow. Infants with prolonged central or mixed apnea were then treated with caffeine and restudied. Caffeine reduced the total number of apneic episodes of greater than 10 sec duration by 80% (P less than 0.01) and prolonged episodes of apnea (greater than 20 sec) by 88% (P less than 0.05). These data suggest that caffeine may be effective in the management of apnea of prematurity, particularly the prolonged type, unresponsive to theophylline.