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Heart Disease (Expert Forum)
Apnea and Bradycardia
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Apnea and Bradycardia
by TK, Oct 10, 1999 12:00AM
I have a premature infant who was born 3 months early at a weight of 1 pound, 15 ounces. The baby boy had continuous apnea spells in NICU and was released on a monitor 10 weeks following the birth. He was released at a weight of 5 pounds 6 ounces. He has been home for 10 weeks now and has been taking .75 cc's of theophylline every 8 hours. The baby boy grew to 9 and 1/2 pounds recently and our doctor took him off theophylline "cold turkey". We thought all was well and went on an outing to the zoo for a couple of hours 3 days after he was taken off theophylline. The boy had a bradycardia episode in the car where the monitor went to 6 beeps per second and he turned white. We revived him and needless to say were terrified as he went away in the ambulance to ER.
Now, we have been told to increase theophylline to 1 cc every 8 hours for the next couple of months.
My questions are, in your professional opinion, "Should the theophylline dose be monitored as his weight gains, i.e. should his dose be increased or weened (rather than cold turkey) in the coming months?" "How can we avoid another bradycardia episode?" Does theophylline have any long term effects, as he will be on theophylline for the first 6 months of his life?" "When does this all seem to be outgrown by the infant where we might feel comfortable that our little boy will not have these so called "A & B " spells, i.e., is there a certain magic age where the brain develops enough to remember to breathe?"
Thank you.
Now, we have been told to increase theophylline to 1 cc every 8 hours for the next couple of months.
My questions are, in your professional opinion, "Should the theophylline dose be monitored as his weight gains, i.e. should his dose be increased or weened (rather than cold turkey) in the coming months?" "How can we avoid another bradycardia episode?" Does theophylline have any long term effects, as he will be on theophylline for the first 6 months of his life?" "When does this all seem to be outgrown by the infant where we might feel comfortable that our little boy will not have these so called "A & B " spells, i.e., is there a certain magic age where the brain develops enough to remember to breathe?"
Thank you.
Doctor's Answer
by CCF CARDIO MD - DLB, Oct 11, 1999 12:00AM
It does seem reasonable to continue the theophylline for the time being. THe dose will likely need to be adjusted upwards as he gains weight. Stopping it cold turkey was not unreasonable, but probably next time it would be better to take him off the medication a little more slowly. As long as the dose is not too high, it should not cause any long term adverse effects. As his brain develops over the next several months, his breathing system should start working on its own.
