When to start and stop caffeine and why respiratory status matters

Davis, Peter G

doi:10.1016/j.siny.2020.101175

Cited by 9 publications

(9 citation statements)

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“…Caffeine Therapy in Apnea of Prematurity: Traditional Review Özmert Muhammet Ali ÖZDEMİR a a Pamukkale Üniversitesi Tıp Fakültesi, Neonatoloji BD, Denizli, Türkiye Bu çalışma, Türk Neonatoloji Derneği "Prematüre Bebek Yönetimi; Deneyim ve Kanıta Dayalı Güncel Yaklaşımlar" Sempozyumu'nda (26)(27)(28)(29) Mayıs 2022, Antalya) sözlü olarak sunulmuştur.…”

Section: Prematüre Apnesinde Kafein Tedavisi: Geleneksel Derlemeunclassified

“…25 Yakın tarihli bir derlemede de aşırı prematüre bebeklerde kafeinin postmenstrüel 34 haftaya kadar kullanılabileceği, ancak daha immatür ve BPD'li olan bebeklerde sürenin 2-3 hafta kadar uzatılabileceği, kafein tedavisi kesildikten sonra ise 5-7 gün daha bu bebeklerin apne/bradikardi bakımından monitörize edilmesi gerektiği rapor edilmektedir. 26 Gebelik haftası 26-32 arasında olan, standart kafein tedavisi (yükleme 20 mg/kg, idame 5 mg/kg/gün) uygulanan ve apnesiz 7 gün sonra kafeini kesilen bir grup ile (n=60) 34 GH'ye kadar kafein alıp apnesiz 7 gün sonra kafeini kesilen diğer grubun (n=60) karşılaştırıldığı Hindistan'dan bildirilen randomize kontrollü bir çalışmada; 2 grup arasında apne tekrarı ve yan etki bakımından bir farklılık yokken, 7 gün apnesiz dönem sonrası kafein kesilenlerde beklenildiği üzere kafein kullanım süresi ve kesilme zamanı daha kısa olarak saptanmıştır. Ayrıca bu çalışmada, 26-29 GH ile 30-32 GH'yi içeren subgrup analizi yapıldığında; 29 gebelik haftası ve altında doğanlarda apne %74 sonlanırken, 30-32 GH'de apne %96 sonlanmakta, yani daha düşük gebelik haftasında doğanlarda apne tekrarının daha fazla görüldüğü bildirilmiştir.…”

Section: Kafein Etki Mekanizmasiunclassified

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Caffeine Therapy in Apnea of Prematurity: Traditional Review

ÖZDEMİR¹

2023

Turkiye Klinikleri J Pediatr

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prematurity, increases neural excitation by preventing gammaaminobutyric acid release, increases the sensitivity of the central nervous system to blood carbon-dioxide levels, thus it stimulates and maintains respiration in infants with apnea. In this review, the effect of caffeine, which is the first choice in the treatment of apnea in premature infants, information about who, when, in which dose, and for how long we should use it, has been tried to be given in the light of the recent literature data.

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Section: Prematüre Apnesinde Kafein Tedavisi: Geleneksel Derlemeunclassified

Section: Kafein Etki Mekanizmasiunclassified

Caffeine Therapy in Apnea of Prematurity: Traditional Review

ÖZDEMİR¹

2023

Turkiye Klinikleri J Pediatr

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“…10,11 Currently, prophylactic caffeine is usually prescribed in the neonatal intensive care unit (NICU) for preterm neonates with respiratory distress syndrome (RDS) weighing less than 1250 g. 12 Although the effect of respiratory stimulant caffeine in the neonatal population has been well established, routine use of prophylactic caffeine for preterm infants with birth weights greater than 1250 g receiving noninvasive respiratory support is not common. 12,13 Our trial evaluated the effectiveness of prophylactic caffeine in premature infants with RDS who were under respiratory support with nasal CPAP, and their birth weights were 1250-2000 g. We examined the effect of caffeine therapy in reducing the duration of noninvasive respiratory support and oxygen requirements in two caffeine-treated and control groups. We also compared other factors, such as AOP, bronchopulmonary dysplasia, PDA, NEC, pneumothorax, IVH, seizure, nosocomial sepsis, ROP, and duration of hospitalization in the NICU, between the two groups.…”

Section: Introductionmentioning

confidence: 99%

Effect of Prophylactic Caffeine on Noninvasive Respiratory Support in Preterm Neonates Weighing 1250–2000 g: A Randomized Controlled Trial

et al. 2022

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Background: Caffeine is commonly used to prevent or treat apnea in preterm neonates. The present trial was designed to determine the effect of caffeine on reducing the time required for nasal continuous positive airway pressure (NCPAP) in neonates with respiratory distress syndrome (RDS). Methods: In a randomized controlled trial, a total of 90 neonates (birth weight between 1250 and 2000 g) who were clinically diagnosed with RDS were subjected to random assignment to one of the two groups of caffeine (n=45) or control (n=45). Infants in the caffeine group received 20 mg/kg caffeine as the initial dose, and then 10 mg/kg daily as the maintenance dose. Infants in the control group did not receive any placebo or similar drugs. The primary outcome was the duration time of respiratory support with NCPAP. Results: The mean (SD) duration of NCPAP differed significantly and was shorter among the infants in the caffeine group than those assigned to the control group (41.53 (43.25) versus 78.48 (114.25) hours, respectively; mean difference: -36.95; 95%CI: -73.14, -0.76; P = 0.04). Apnea of prematurity (AOP) occurred in 2 (4.4%) newborns in the caffeine group and in 9 (20%) of the infants in the control condition [proportion difference: -15.6% (-29.8,-1.8); (P = 0.02)]. The incidence of intraventricular hemorrhage (IVH) was higher in the control group than in the caffeine group after one week (P = 0.03). The incidence of chronic lung disease (CLD), infection, necrotizing enterocolitis (NEC), seizure, vomiting and pneumothorax was similar in the two groups. Conclusion: The results suggest that preventative caffeine can reduce the duration of NCPAP support in neonates with RDS.

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“…Caffeine is one of the most commonly used drugs in the neonatal unit and its use has increased enormously following the publication of Caffeine for Apnoea of Prematurity trial (CAP) 1,2 . There is enough evidence that caffeine is an effective drug for the treatment of apnoea of prematurity with other potential short‐ and long‐term benefits 3,4 . Although there is robust evidence of the use of caffeine in the neonatal population, we expected a variation in practice with use of caffeine among neonatal units in the United Kingdom.…”

Section: Introductionmentioning

confidence: 99%

National survey on caffeine use in neonatal units across the United Kingdom

2022

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AimTo understand the variations in practice for caffeine use among neonatal units in the United Kingdom.MethodsAn online survey was sent to every neonatal unit in the United Kingdom.ResultsWe received a response from 92 neonatal units (47%) with the proportion of response from special care, Local neonatal units, neonatal intensive care units and neonatal surgical units were 23%, 34%, 23% and 21% respectively. All the units reported the use of caffeine, and 40 units (46%) initiated caffeine within 24 h of birth. Fifty‐nine units (64%) reported routine use of caffeine for pre‐term infants <32 weeks. Seventy‐one units (77%) reported that they continue caffeine for infants needing mechanical ventilation. Thirty‐one units (34%) discontinued caffeine at 34 weeks post‐menstrual age, irrespective of the respiratory support. Ten units (11%) reported discontinuation of caffeine only after weaning off all respiratory support, and 40% of units had a variable practice of discontinuing caffeine depending on the individual baby. Seventy‐nine units (86%) reported they would regularly optimise caffeine dose based on weight checks.ConclusionOur survey showed some variation in practice with regards to the timing of caffeine initiation, gestational age cut‐off for routine caffeine prescription and discontinuation.

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When to start and stop caffeine and why respiratory status matters

Cited by 9 publications

References 43 publications

Caffeine Therapy in Apnea of Prematurity: Traditional Review

Caffeine Therapy in Apnea of Prematurity: Traditional Review

Effect of Prophylactic Caffeine on Noninvasive Respiratory Support in Preterm Neonates Weighing 1250–2000 g: A Randomized Controlled Trial

National survey on caffeine use in neonatal units across the United Kingdom

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