Apnoea of immaturity. 1. A controlled trial of theophylline and face mask continuous positive airways pressure.

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Abstract
A randomized controlled trial of theophylline vs. face-mask continuous positive airways pressure (CPAP) treatment for recurrent apnea of immaturity was carried out in 32 infants of 25-32 wk gestation. Continuous recording of ECG and impedance pneumogram added objective assessment to the nurses'' observations for 11 courses of treatment. The CPAP group had more adverse perinatal factors but the frequency of apneic attacks before treatment was comparable. Infants given theophylline had a greater reduction in the incidence of prolonged apneic attacks; this difference persited after allowing for the effect of perinatal complications. Continuous recordings showed a greater reduction in episodes of bradycardia of .ltoreq. 80/min with theophylline. Of 18 infants given theophylline; 5 needed intermittent positive pressure ventilation for apnea compared with 12 of 14 given CPAP. The poor response in 17 of 32 infants suggests a need for a more effective method of preventing or treating apnea in very immature babies, in whom adverse perinatal factors often coexist.