Role of aminophylline in prevention of acute kidney injury in term neonates with severe perinatal asphyxia: a randomized open-label controlled trial.

IF 1.8 4区 医学 Q2 PEDIATRICS Journal of Tropical Pediatrics Pub Date : 2024-10-04 DOI:10.1093/tropej/fmae036
Dinesh Munian, Sukanta Dutta, Arindam Ghosh, Ripan Saha
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Abstract

Acute kidney injury (AKI) is one of the frequently observed complications in neonates with severe perinatal asphyxia. The efficacy of aminophylline in preventing or alleviating renal dysfunction in these neonates remains controversial. The current study aimed to explore whether treatment with aminophylline as adjunctive therapy is superior to standard care alone in preventing AKI in severely asphyxiated term neonates and to delineate the changes in other renal parameters. In this open-label randomized clinical trial, term neonates with severe asphyxia (n = 41) received a 5 mg/kg intravenous dose of aminophylline within the first hour after birth, in addition to standard care for birth asphyxia. The control group (n = 40) received standard care alone. Their daily urine output, weight, serum creatinine, renal functional status, and complications during the first 5 days of life were monitored and compared. The statistical package for social sciences version 25 was used for analysis. Approximately 24.39% of neonates in the aminophylline group developed AKI, compared to 35.0% in the control group (P = .088). Although urine output was generally higher in aminophylline-treated newborns than in the control group, this increase was not statistically significant (P > .05), with the most notable differences observed on the second and third postnatal days. Also, the changes in plasma creatinine levels between the two groups during this time were not statistically significant. Administering a single dose of aminophylline (5 mg/kg) within the first hour of life to severely asphyxiated term neonates might temporarily enhance urine output, but does not reduce the overall incidence of AKI.

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氨茶碱在预防重度围产期窒息的足月新生儿急性肾损伤中的作用:随机开放标签对照试验。
急性肾损伤(AKI)是围产期重度窒息新生儿经常出现的并发症之一。氨茶碱在预防或缓解这些新生儿肾功能障碍方面的疗效仍存在争议。本研究旨在探讨氨茶碱作为辅助疗法在预防严重窒息的足月新生儿发生 AKI 方面是否优于单纯的标准治疗,并了解其他肾脏参数的变化。在这项开放标签随机临床试验中,患有重度窒息的足月新生儿(n = 41)在出生后一小时内接受了 5 mg/kg 剂量的氨茶碱静脉注射,同时还接受了针对出生窒息的标准治疗。对照组(40 人)只接受标准护理。对他们出生后最初 5 天的每日尿量、体重、血清肌酐、肾功能状态和并发症进行监测和比较。分析使用的是社会科学统计软件包第 25 版。氨茶碱组约有 24.39% 的新生儿发生了 AKI,而对照组为 35.0%(P = .088)。虽然氨茶碱治疗组新生儿的尿量普遍高于对照组,但这一增长并无统计学意义(P > .05),最明显的差异出现在出生后的第二和第三天。此外,在此期间,两组间血浆肌酐水平的变化也没有统计学意义。在严重窒息的足月新生儿出生后一小时内给予单剂量氨茶碱(5 毫克/千克)可能会暂时增加尿量,但不会降低 AKI 的总体发病率。
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来源期刊
Journal of Tropical Pediatrics
Journal of Tropical Pediatrics 医学-热带医学
CiteScore
4.00
自引率
0.00%
发文量
97
审稿时长
6-12 weeks
期刊介绍: The Journal of Tropical Pediatrics provides a link between theory and practice in the field. Papers report key results of clinical and community research, and considerations of programme development. More general descriptive pieces are included when they have application to work preceeding elsewhere. The journal also presents review articles, book reviews and, occasionally, short monographs and selections of important papers delivered at relevant conferences.
期刊最新文献
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