Clinical effect of different maintenance doses of caffeine citrate in the treatment of preterm infants requiring assisted ventilation: a pilot multicenter study.

Abstract

OBJECTIVES:

To explore the optimal maintenance dose of caffeine citrate for preterm infants requiring assisted ventilation and caffeine citrate treatment.

METHODS:

A retrospective analysis was performed on the medical data of 566 preterm infants (gestational age ≤34 weeks) who were treated and required assisted ventilation and caffeine citrate treatment in the neonatal intensive care unit of 30 tertiary hospitals in Jiangsu Province of China between January 1 and December 31, 2019. The 405 preterm infants receiving high-dose (10 mg/kg per day) caffeine citrate after a loading dose of 20 mg/kg within 24 hours after birth were enrolled as the high-dose group. The 161 preterm infants receiving low-dose (5 mg/kg per day) caffeine citrate were enrolled as the low-dose group.

RESULTS:

Compared with the low-dose group, the high-dose group had significant reductions in the need for high-concentration oxygen during assisted ventilation (P=0.044), the duration of oxygen inhalation after weaning from noninvasive ventilation (P<0.01), total oxygen inhalation time during hospitalization (P<0.01), the proportion of preterm infants requiring noninvasive ventilation again (P<0.01), the rate of use of pulmonary surfactant and budesonide (P<0.05), and the incidence rates of apnea and bronchopulmonary dysplasia (P<0.01), but the high-dose group had a significantly increased incidence rate of feeding intolerance (P=0.032). There were no significant differences between the two groups in the body weight change, the incidence rates of retinopathy of prematurity, intraventricular hemorrhage or necrotizing enterocolitis, the mortality rate, and the duration of caffeine use (P>0.05).

CONCLUSIONS:

This pilot multicenter study shows that the high maintenance dose (10 mg/kg per day) is generally beneficial to preterm infants in China and does not increase the incidence rate of common adverse reactions. For the risk of feeding intolerance, further research is needed to eliminate the interference of confounding factors as far as possible.

• Authors: Yang Yang, Ke-Yu Lu, Rui Cheng, Qin Zhou, Guang-Dong Fang, Hong Li, Jie Shao, Huai-Yan Wang, Zheng-Ying Li, Song-Lin Liu, Zhen-Guang Li, Jin-Lan Cai, Mei Xue, Xiao-Qing Chen, Zhao-Jun Pan, Yan Gao, Li Huang, Hai-Ying Li, Lei Song, San-Nan Wang, Gui-Hua Shu, Wei Wu, Meng-Zhu Yu, Zhun Xu, Hong-Xin Li, Yan Xu, Zhi-Dan Bao, Xin-Ping Wu, Li Ye, Xue-Ping Dong, Qi-Gai Yin, Xiao-Ping Yin, Jin-Jun Zhou, Jiangsu Premature Infant Respiratory Failure Cooperation
• Journal: Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics (Zhongguo Dang Dai Er Ke Za Zhi) Vol. 24 Issue 3 Pg. 240-248 (Mar 15 2022) ISSN: 1008-8830 [Print] China
• Vernacular Title: 不同维持剂量枸橼酸咖啡因对辅助通气早产儿的疗效评估：一项初步多中心研究.
• PMID: 35351252 (Publication Type: Journal Article, Multicenter Study)

Chemical References

• Citrates
• Caffeine
• caffeine citrate

Topics

• Caffeine (therapeutic use)
• Citrates
• Humans
• Infant
• Infant, Newborn
• Infant, Premature
• Respiration, Artificial
• Retrospective Studies