Perbandingan Keamanan Aminofilin dan Kafein pada Bayi Prematur dengan Apne Prematuritas

Dian Artanti, Rinawati Rohsiswatmo, Rosalina Dewi Roeslani

Sari


Latar belakang. Apne berulang sering terjadi pada bayi prematur. Kejadian ini dapat menimbulkan hipoksemia dan bradikardi , bila keadaannya semakin memburuk maka membutuhkan resusitasi dengan ventilasi tekanan positif. Obat golongan metilxantin (kafein dan teofilin) telah digunakan untuk mencegah apne.
Tujuan. Untuk mengetahui efek dan keamanan kafein dibandingkan teofilin pada bayi preamtur dengan periodik apne.
Metode. Penelusuran pustaka database elektronik : Pubmed, Cochrane, dan Highwire
Hasil. Hasil telaah sistematis menunjukkan kejadian takikardia dan intoleransi minum lebih sedikit pada kelompok kafein dengan Relative Risk (RR) 0,17; 95 % Interval kepercayaan (IK) 0,04, 0,72; risk difference (RD) -0,29; 95 % IK -0,47, - 0,10. Studi klinis acak mendapatkan Tidak ada hubungan bermakna antara dosis pemberian kafein dan aminofilin pada konsentrasi plasma keduanya, kecuali pada kelompok kafein pada hari tertentu.
Kesimpulan. Aminofilin dan kafein memiliki efektivitas yang sama dalam mengatasi apne pada bayi prematur. Efek toksisitas kafein lebih rendah dibandingkan aminofilin.


Kata Kunci


bayi prematur; apne; kafein; teofilin

Teks Lengkap:

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Referensi


Sari S, Tjipta GD, Aldy D. Pengguan metilxantin pada bayi prematur dengan apne idiopatik. Sari Pediatri 2004;6:129-33.

Schoen K, Yu T, Stockmann C, Spigarelli MG, Sherwin CM. Use of methylxanthine therapies for the treatment and prevention of apnea of prematurity. Paediatr Drugs 2014;16:169-77.

Theobald K, Botwinski C, Albanna S, McWilliam P. Apnea of prematurity: diagnosis, implications for care, and pharmacologic management. Neonatal Netw 2000;19:17-24.

Montandon G, Bairam A, Kinkead R. Long-term consequences of neonatal caffeine on ventilation, occurrence of apnes, and hypercapnic chemoreflex in male and female rats. Pediatr Res 2006;59:519-24.

Natarajan G, Lulic-Botica M, Aranda JV. Pharmacologic review: clinical pharmacology of caff in the newborn. Neoreviews 2007;8:e214-21.

Oxford Centre of Evidence-Based Medicine 2011 Levels of Evidence [diakses 15 Juni 2016]. Didapat dari: http:// www.cebm.net/wp-content/uploads/2014/06/CEBM- Levels-of-Evidence-2.1.pdf2011

Henderson-Smart DJ, Steer PA. Caffeine versus theophylline for apne in preterm infants. Cochrane Database Syst Rev [internet]. 2010 [disitasi 4 Juni 2016]. Didapat dari: http://onlinelibrary.wiley.com/ doi/10.1002/14651858.CD000273.pub2/pdf

Bairam A, Boutroy MJ, Badonnel Y, Vert P. Theophylline versus caffeine: comparative effects in treatment of idiopathic apne in the preterm infant. J Pediatr 1987;110:636–9.

Scanlon JE, Chin KC, Morgan ME, Durbin GM, Hale KA, Brown SS. Caffeine or theophylline for neonatal apnoea? Arch Dis Child 1992;67:425–8.

Brouard C, Moriette G, Murat I, Flouvat B, Pajot M, Waiti H, dkk. Comparative efficacy of theophylline and caffeine in the treatment of idiopathic apne in premature infants. Am J Dis Child 1985;139:698-700.

Skouroliakou M, Bacopoulou F, Markantonis SL. Caffeine versus theophylline for apnea of prematurity: a randomised controlled trial. J Paediatr Child Health 2009;45:587-92.

Eichenwald EC. Apnea of prematurity. Pediatrics 2016;137:1-8.

Abu Jawdeh EG, O’Riordan M, Limrungsingkul A, Bandyopadhyay A, Argus BM, Nakad PE, dkk. Methylxanthine use for apnea of prematurity among an international cohort of neonatologist. J Neonatal Perinatal Med 2013;103;251-6.

Dukhovny D, Lorch SA, Schmidt B, Doyle LW, Kok JH, Roberts RS, dkk. Economic evaluation of caffeine for apnea of prematurity. Pediatrics 2011;127:e146–55.

Gray PH, Flenady VJ, Charles BG, Steer PA. Caffeine citrate for very preterm infants: effects on development, temperament and behaviour. J Paediatr Child Health 2011;47:167–72.

Schmidt B, Roberts RS, Davis P, Doyle LW, Barrington KJ, Ohlsson A, dkk. Caff therapy for apnea of prematurity. N Engl J Med 2006;354:2112–21.

Dobson NR, Patel RM, Smith PB, Kuehn DR, Clark J, Vyas-Read S, dkk. Trends in caffeine use and association between clinical outcomes and timing of therapy in very low birth weight infants. J Pediatr 2014;164:992–98.




DOI: http://dx.doi.org/10.14238/sp19.2.2017.108-13

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