Laboratory of Experimental Surgery and Surgical Research NS Christeas, Athens University Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Department of Neonatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
J Matern Fetal Neonatal Med. 2021 Sep;34(18):3080-3088. doi: 10.1080/14767058.2019.1673722. Epub 2019 Oct 7.
To evaluate the effects of prophylactic theophylline in renal function and survival rates of asphyxiated newborns.
Medline, Scopus, Cochrane Central Register of Controlled Trials, Clinicaltrials.gov and Google Scholar databases were systematically searched. All randomized controlled trials evaluating the efficacy of theophylline in the prevention of perinatal asphyxia were selected.
A total of seven studies were included with a total of 458 asphyxiated neonates. Incidence of acute kidney injury was significantly lower in neonates receiving theophylline (OR: 0.24, 95% CI: [0.16, 0.36]), while mortality rates were similar between the two groups (OR: 0.86, 95% CI: [0.46, 1.62]). Theophylline administration was associated with significantly decreased serum creatinine levels (MD: -0.57 mg/dl, 95% CI: [-0.68, -0.46]) and elevated glomerular filtration rate (MD: 13.79 ml/min/1.73 m, 95% CI: [11.91, 15.68]) in the third day of life. Theophylline also lead to lower β2-microglobulin levels, higher urine output and negative fluid balance.
The present findings suggest the effectiveness of theophylline in ameliorating renal function of asphyxiated neonates. Future large-scale trials should assess potential long-term adverse outcomes in clinical practice.KeynotesAsphyxia is a major cause of acute kidney injury in neonatesAcute kidney injury is associated with adverse clinical outcomes in asphyxiated neonates.Theophylline administration leads to significantly lower incidence of acute kidney injury in asphyxiated neonates.
评估预防性茶碱对窒息新生儿肾功能和存活率的影响。
系统检索 Medline、Scopus、Cochrane 中央对照试验注册库、Clinicaltrials.gov 和 Google Scholar 数据库。选择评估茶碱预防围产期窒息疗效的所有随机对照试验。
共纳入 7 项研究，共 458 例窒息新生儿。接受茶碱治疗的新生儿急性肾损伤发生率显著降低（OR：0.24，95%CI：[0.16，0.36]），而两组死亡率相似（OR：0.86，95%CI：[0.46，1.62]）。茶碱给药与血清肌酐水平显著降低（MD：-0.57mg/dl，95%CI：[-0.68，-0.46]）和肾小球滤过率升高（MD：13.79ml/min/1.73m，95%CI：[11.91，15.68]）有关。茶碱还导致β2-微球蛋白水平降低、尿量增加和负液体平衡。
目前的研究结果表明茶碱可改善窒息新生儿的肾功能。未来的大规模试验应评估在临床实践中潜在的长期不良结局。
窒息是新生儿急性肾损伤的主要原因；急性肾损伤与窒息新生儿的不良临床结局相关；茶碱给药可显著降低窒息新生儿急性肾损伤的发生率。
