Effect of caffeine on pneumogram and apnoea of infancy.

Anwar, Mujahid; Mondestin, Harry; Mojica, Neal; Novo, Robert; Graff, Michael; Hiatt, Mark; Hegyi, Thomas

doi:10.1136/adc.61.9.891

Cited by 24 publications

(16 citation statements)

References 13 publications

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“…[96] Improvement in pneumogram abnormalities with resolution of clinically important apnea was observed in a study that used the higher maintenance dose of 5 mg/kg. [97] Several other studies have reported similar findings for reduction of episodes of apnea and pneumogram improvements using dosages of 2.5-5 mg/kg/day, following loading doses of 10-20 mg/kg (table I). [97][98][99] In the study by Boutroy et al, [38] the effects of caffeine were evaluated after administration of theophylline.…”

Section: Clinical Trials With Caffeinesupporting

confidence: 60%

“…[97] Several other studies have reported similar findings for reduction of episodes of apnea and pneumogram improvements using dosages of 2.5-5 mg/kg/day, following loading doses of 10-20 mg/kg (table I). [97][98][99] In the study by Boutroy et al, [38] the effects of caffeine were evaluated after administration of theophylline. The plasma levels of theophylline and caffeine were determined following theophylline doses, and the frequency of apnea evaluated.…”

Section: Clinical Trials With Caffeinesupporting

confidence: 60%

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Treatment of Apnea of Prematurity

Bhatt‐Mehta

Schumacher

2003

Pediatric Drugs

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In the last decade, knowledge regarding the neurodevelopment and functional aspects of the respiratory centers during postnatal maturation has increased substantially. However, an increase in such knowledge has not provided a basis for change in practice. The diagnosis of apnea of prematurity (AOP) is one of exclusion. All causes of secondary apnea must be ruled out before initiating treatment for AOP. Treatment will depend on the etiology as well as effectiveness and tolerability of the treatment by the patient. The primary goal of any treatment of AOP is to prevent the frequency of apnea lasting >20 seconds, and/or those that are shorter, but associated with cyanosis and bradycardia. The clinical management of AOP is not much different today than it was two decades ago, with pharmacologic and nonpharmacologic treatment options remaining the mainstay of therapy. Methylxanthines are still the most widely used pharmacologic agents. Due to the wider therapeutic index of caffeine and ease of once daily administration, it should be the preferred agent. Doxapram, or nonpharmacologic treatment measures such as nasal continuous positive airway pressure, may be considered in infants who are unresponsive to methylxanthine treatment alone. Treatment should be continued until there is complete resolution of apnea, and for some time thereafter. The choice of method for weaning treatment remains one of individual physician preference. Discharge from hospital after apnea requires close monitoring and some infants will require home apnea monitors. The decision to provide a home apnea monitor should be individualized for each patient, depending on the effectiveness of treatment and clinical response.

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Section: Clinical Trials With Caffeinesupporting

confidence: 60%

Section: Clinical Trials With Caffeinesupporting

confidence: 60%

Treatment of Apnea of Prematurity

Bhatt‐Mehta

Schumacher

2003

Pediatric Drugs

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“…[16][17][18] Information pertaining to the clinical utility of other diagnostic studies in the setting of ABD events is less clear. The overwhelming majority of infants were subject to glucose testing and blood culture screening reflecting routine NICU practice irrespective of ABD occurrence.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Evaluation and Home Monitor Use in Late Preterm to Term Infants With Apnea, Bradycardia, and Desaturations

Veit

Amberson

Freiberger

et al. 2016

Clin Pediatr (Phila)

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Apnea, bradycardia, and oxygen desaturation events are a common in neonatal intensive care units, with relevant literature to date largely focusing on very low birth weight and extremely low birth weight infants. We conducted a retrospective review of infants born at ≥34 weeks gestational age at 2 tertiary neonatal intensive care units in Boston, MA, between January 2009 and December 2013. Our objectives included (1) describing the diagnostic evaluations performed in late preterm to term infants with discharge-delaying apnea, bradycardia, or oxygen desaturation events and (2) identifying variables associated with home monitor use. Of the 741 eligible infants identified, diagnostic evaluations were variable and infrequent with blood culture, blood glucose, and head ultrasound performed most commonly. The likelihood of home monitor use was greater in infants with either a prolonged inpatient stay or greater gestational age at birth.

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“…[56][57][58] However, very few randomised studies have been conducted to confirm these initial findings (table II). [56][57][58] However, very few randomised studies have been conducted to confirm these initial findings (table II).…”

Section: First-line Therapymentioning

confidence: 99%

“…[53,[59][60][61]66] In 1 trial there was a small, statistically significant (p < 0.05) rise in heart rate of 3 or 5 beats/minute on the fourth day of treatment with caffeine citrate 6 or 12 mg/kg/day, respectively. [56] A high dose regimen of caffeine citrate (60 mg/kg loading dose followed by 30 mg/kg/day) in premature neonates about to be extubated was associated with jitteriness and increased agitation after 7 days of treatment; 5 of the 17 infants had plasma caffeine concentrations of >70 mg/L. [56] A high dose regimen of caffeine citrate (60 mg/kg loading dose followed by 30 mg/kg/day) in premature neonates about to be extubated was associated with jitteriness and increased agitation after 7 days of treatment; 5 of the 17 infants had plasma caffeine concentrations of >70 mg/L.…”

Section: Tolerabilitymentioning

confidence: 99%

Caffeine Citrate

Comer¹,

Perry²,

Figgitt³

2001

Paediatric Drugs

107

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Caffeine citrate was generally well tolerated by neonates in clinical trials and it decreased the incidence of apnoea of prematurity compared with placebo. It has demonstrated similar efficacy to theophylline, but is generally better tolerated and has a wider therapeutic index. Caffeine citrate should, therefore, be considered the drug of choice when pharmacological treatment of apnoea of prematurity is required.

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Effect of caffeine on pneumogram and apnoea of infancy.

Cited by 24 publications

References 13 publications

Treatment of Apnea of Prematurity

Treatment of Apnea of Prematurity

Diagnostic Evaluation and Home Monitor Use in Late Preterm to Term Infants With Apnea, Bradycardia, and Desaturations

Caffeine Citrate

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