Caffeine Citrate for the Treatment of Apnea of Prematurity: A Double‐Blind, Placebo‐Controlled Study

Erenberg, Allen; Leff, Richard D.; Haack, Dennis; Mosdell, Kristen W.; Hicks, Gregory M.; Wynne, Beverley A.; Group, Caffeine Citrate Study

doi:10.1592/phco.20.7.644.35167

Cited by 124 publications

(111 citation statements)

References 28 publications

Supporting

Mentioning

104

Contrasting

Unclassified

Order By: Relevance

“…10 The median birth weight for all the patients treated with aminophylline was 1 400 g and those treated with caffeine was 1 600 g. The incidence of AOP in this patient population is 25%. 11 Both these parameters in the two study arms were comparable.…”

Section: Discussionmentioning

confidence: 85%

Caffeineversusaminophylline for the prevention of apnoea of prematurity in a teaching hospital in South Africa

Schellack

Gous

Mawela

2015

South African Family Practice

View full text Add to dashboard Cite

Study objectives:To determine the safety and efficacy of the use of oral anhydrous caffeine and intravenous aminophylline in the neonatal population using therapeutic drug levels and clinical effects as markers for determination. Design: Prospective randomised study. Patients: Thirty-one neonates admitted (aminophylline n = 16, caffeine n = 15) with a gestational age of less than or equal to 34 weeks for prevention of apnoea of prematurity (AOP) were enrolled. Results: Oral anhydrous caffeine or intravenous aminophylline were administered using prescribed study regimens. One peak level was taken for the two drugs on day 4 of treatment 2 hours after the maintenance dose was administered. The two regimens were clinically monitored using cardiovascular, respiratory, gastro-intestinal and central nervous system parameters four hourly. The two groups did not differ significantly for gestational age (p = 0.782), birth weight (p = 1), gender (p = 0.722), and Apgar scores determined at 5 minutes (p = 0.068). Serum concentrations were within range (5-20 μg/ml) for both study groups. The median pulse rate (beats per minute) for two days; day 7: 160 vs. 148 (p = 0.019); day 9: 168 vs. 147 (p = 0.020) and median respiratory rate (breaths per minute) for five days; day 3: 68 vs. 61 (p = 0.039); day 4: 67 vs. 57 (p = 0.014); day 5: 64 vs. 58 (p = 0.045); day 7: 65 vs. 50 (p = 0.021); day 8: 66 vs. 56 p = 0.014) were significantly higher in the aminophylline study arm. Conclusion:The findings of the study indicated that caffeine is an effective alternative for intravenous aminophylline in prevention of AOP. The oral administration of caffeine may also have an advantage in a resource-poor setting.

show abstract

Section: Discussionmentioning

confidence: 85%

Caffeineversusaminophylline for the prevention of apnoea of prematurity in a teaching hospital in South Africa

Schellack

Gous

Mawela

2015

South African Family Practice

View full text Add to dashboard Cite

show abstract

“…70 Multiple clinical trials have shown that both caffeine and theophylline are effective treatment for AOP. [71][72][73][74] Initially theophylline was the standard therapy and it required close monitoring of serum levels. Since Food and Drug Administration approval of caffeine, theophylline has been largely replaced by caffeine as the first line of management.…”

Section: Treatment Strategiesmentioning

confidence: 99%

Apnea of prematurity: pathogenesis and management strategies

Mathew

2010

J Perinatol

109

View full text Add to dashboard Cite

Apnea of prematurity (AOP) is a significant clinical problem manifested by an unstable respiratory rhythm reflecting the immaturity of respiratory control systems. This review will address the pathogenesis of and treatment strategies for AOP. Although the neuronal mechanisms leading to apnea are still not well understood, recent decades have provided better insight into the generation of the respiratory rhythm and its modulation in the neonate. Ventilatory responses to hypoxia and hypercarbia are impaired and inhibitory reflexes are exaggerated in the neonate. These unique vulnerabilities predispose the neonate to the development of apnea. Treatment strategies attempt to stabilize the respiratory rhythm. Caffeine remains the primary pharmacological treatment modality and is presumed to work through blockade of adenosine receptors A 1 and A 2 . Recent evidences suggest that A 2A receptors may have a greater role than previously thought. AOP typically resolves with maturation suggesting increased myelination of the brainstem.

show abstract

“…Advances in neonatal care in recent decades have resulted in an increased survival rate in low-birth-weight premature infants. Therefore, the number of newborns with this disorder is increasing (Erenberg & Allen, 2000).…”

Section: Is Caffiene a Risk For Op? 49mentioning

confidence: 99%

53: Is Caffeine a Risk Factor for Osteopenia of Prematurity?

Ali

De-wen

2015

Paediatrics &Amp; Child Health

View full text Add to dashboard Cite

Caffeine, the most common used medication in NICUs, has calciuric and osteoclasteogenesis effects. Objectives:To examine the association of caffeine cumulative dose and duration of therapy and the Osteopenia of prematurity (OP) Study design: A retrospective observational cohort study included premature infants less than 31 weeks and birth weight less than 1500 grams. OP was evaluated using chest X-rays on biweekly basis over 12 weeks hospital stay. Caffeine cumulative dose and duration of therapy, steroid dose and diuretic dose along with other maternal and neonatal risk factors were collected to examine their impact on OP. Results:The cohort included 109 infants. 51% had OP and 8% had spontaneous rib fractures.Using the generalized mixed model, Caffeine dose and duration of caffeine displayed strong association with OP. Steroids and vitamin D had significant correlation with OP while diuretic use did not show statistical significant effect. Conclusion:Caffeine cumulative dose and duration of therapy are associated with OP.

show abstract

Caffeine Citrate for the Treatment of Apnea of Prematurity: A Double‐Blind, Placebo‐Controlled Study

Cited by 124 publications

References 28 publications

Caffeineversusaminophylline for the prevention of apnoea of prematurity in a teaching hospital in South Africa

Caffeineversusaminophylline for the prevention of apnoea of prematurity in a teaching hospital in South Africa

Apnea of prematurity: pathogenesis and management strategies

53: Is Caffeine a Risk Factor for Osteopenia of Prematurity?

Contact Info

Product

Resources

About