Background/Aim Methylxanthines are routinely prescribed to prevent apnoea in preterm infants. Their central nervous system stimulatory effect is well known, but there are only few data on their effect on cerebral cortical activity in preterm infants. Here, we investigated the effect of theophylline administration on cerebral cortical activity using amplitude EEG (aEEG) in preterm infants.

Patient and Methods In 19 preterm infants, gestational age 27 (23–30) weeks (median, range), birth weight 800 (480–1150) g, a theophylline loading dose of 6 mg/kg was administered intravenously over 30 minutes, and aEEG, heart rate, oxygen saturation and pCO₂ were registered continuously from 1 h before to 1 h after theophylline administration. Infants with an aEEG impedance rise >5 kOhm or with simultaneous administration of sedatives were excluded. Average values during 1 h before and 1 h after theophylline calculated for each infant were compared by the Wilcoxon signed rank test.

Results Of the 19 infants studied, four were excluded for rise of impedance and one because of the co-administration of phenobarbitone. In the remaining 14 infants, the average aEEG amplitude increased from 8.0 (3.26–12.35) to 9.33 (7.2–14.03) μV (p<0.01), whereas heart rate increased from 146 (131–175) to 152 (135–187) bpm (p<0.05). Oxygen saturation and pCO₂ did not change.

Conclusions Theophylline increases cerebral cortical activity in preterm infants.