Suwankomonkul Pachima, Thatrimontrichai Anucha, Pakhathirathien Pattima, Praditaukrit Manapat, Maneenil Gunlawadee, Dissaneevate Supaporn, Trangkhanon Chamaiporn, Phon-In Neeracha
Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand.
J Clin Med. 2025 May 30;14(11):3856. doi: 10.3390/jcm14113856.
Preterm neonates with a birth weight (BW) of 500-1250 g who receive prophylactic methylxanthine have a lower rate of bronchopulmonary dysplasia and neurodevelopmental disability than their counterparts. In a meta-analysis of previous studies (published during 1985-1993, with no routine continuous positive airway pressure), extubation failure rates in preterm neonates with BW < 2500 g who received and did not receive methylxanthine were 25.0% and 50.6%, respectively (risk difference, -0.27; 95% confidence interval [CI], -0.39 to -0.15). However, no study to date has assessed the effects of prophylactic methylxanthine use on endotracheal extubation in infants weighing 1250-2499 g until now. : First-time extubation was compared between 1:1 propensity score-matched methylxanthine and non-methylxanthine groups from a retrospective cohort of 541 neonates (born during 2014-2024). : The domains from the overall cohort and propensity-matched data included 541 and 192 neonates, respectively. In the propensity score-matched sample, the mean gestational age and BW were 30.9 ± 1.9 weeks and 1584 ± 273 g, respectively. The median 5-min Apgar score was 9 (range of 7-9). Extubation failure within 7 days occurred in 10 (10.4%) and 13 (13.5%) neonates in the methylxanthine ( = 96) and non-methylxanthine ( = 96) groups, respectively, with a risk difference (95% CI) of -0.03 (-0.12 to 0.06), = 0.50, and hazard ratio (95% CI) of 0.76 (0.33 to 1.72), = 0.51. : In the current era with new non-invasive ventilation approaches, extubation failure in preterm neonates with a BW of 1250-2499 g is not significantly affected by the use of methylxanthine.
出生体重（BW）为500 - 1250克的早产新生儿接受预防性甲基黄嘌呤治疗后，与未接受该治疗的同龄人相比，支气管肺发育不良和神经发育残疾的发生率更低。在一项对先前研究（发表于1985 - 1993年，未常规使用持续气道正压通气）的荟萃分析中，出生体重<2500克且接受和未接受甲基黄嘌呤治疗的早产新生儿拔管失败率分别为25.0%和50.6%（风险差异，-0.27；95%置信区间[CI]，-0.39至-0.15）。然而，迄今为止尚无研究评估预防性使用甲基黄嘌呤对体重1250 - 2499克婴儿气管插管拔管的影响。：从541例新生儿（2014 - 2024年出生）的回顾性队列中，对甲基黄嘌呤组和非甲基黄嘌呤组按1:1倾向评分匹配后比较首次拔管情况。：总体队列和倾向评分匹配数据的样本分别包括541例和192例新生儿。在倾向评分匹配样本中，平均胎龄和出生体重分别为30.9±1.9周和1584±273克。5分钟阿氏评分中位数为9（范围7 - 9）。甲基黄嘌呤组（n = 96）和非甲基黄嘌呤组（n = 96）分别有10例（10.4%）和13例（13.5%）新生儿在7天内出现拔管失败，风险差异（95%CI）为-0.03（-0.12至0.06），P = 0.50，风险比（95%CI）为0.76（0.33至1.72），P = 0.51。：在当前采用新型无创通气方法的时代，出生体重为1250 - 2499克的早产新生儿拔管失败不受甲基黄嘌呤使用的显著影响。
