P0428 / #1825: METHYLXANTHINES USE IN NEONATAL INTENSIVE CARE UNIT: WHAT ARE WE DOING AND WHERE SHALL WE GO?

Abstract

Aims & Objectives: Apnea of prematurity (AOP) is a temporary cessation of breathing for >20 seconds. This phenomenon is observed mostly in infants born at <34 weeks of gestation and is associated to intermittent hypoxia. Although there are concerns about the effects of methylxanthines for AOP, there is strong evidence supporting its benefits. However, there are no clear guidelines for when to discontinue therapy. Commonly, clinicians discontinue therapy around 33-34 weeks’ post menstrual age (PMA) with a 5-7 days observation period. Limited information exists about the recurrence of apnea after a specific event-free period. This project aims to determine AOP incidence during a 5 days off-methylxanthines observational period. Methods: Retrospective medical record review of infants <34 weeks gestational age (GA) admitted to the University Pediatric Hospital Neonatal Intensive Care Unit during 2015-2017 who received methylxanthines for AOP. Statistix 8.0 used for analysis. Results: Subjects included 253 infants; mean birthweight (BW) 1254 grams; mean GA 29 weeks. Median treatment length was up to 34 weeks PMA. AOP post treatment incidence was 4% and was not associated to GA, BW, PMA when treatment stopped or maximum methylxanthines dose. Infants weaned after 34 weeks PMA were more likely to have lower birth weights and be on higher methylxanthines doses (p<0.05). Conclusions: AOP is a common problem affecting preterm neonates. The incidence of AOP after discontinuing treatment was low and not directly associated to PMA suggesting safety in discontinuing treatment at 34 weeks PMA. Still, more research is necessary to clarify optimal treatment regimens.