Weaning very low birthweight infants from mechanical ventilation using intermittent mandatory ventilation and theophylline.

Two very low birthweight infants with severe clinical hyaline membrane disease requiring mechanical ventilation were dependent on slow-rate intermittent mandatory ventilation, without which they developed apnoea or hypopnoea and hypercarbia. Their ventilator dependence was apparently owing to inadequate ventilatory effort, and treatment with oral theophylline allowed easy weaning to continuous-positive airway pressure and extubation. PaCO2 was significantly lower during theophylline treatment, suggesting that the drug may have improved alveolar ventilation.