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©The Author(s) 2015.
World J Clin Pediatr. Nov 8, 2015; 4(4): 81-93
Published online Nov 8, 2015. doi: 10.5409/wjcp.v4.i4.81
Published online Nov 8, 2015. doi: 10.5409/wjcp.v4.i4.81
Table 2 Recommended caffeine doses
Trial | Design | Population | Intervention | Outcomes | Main results |
Scanlon et al[48] United Kingdom | Prospective, randomized, controlled trial | 44 preterm infants less than 31 wk gestation | High (loading 25 mg/kg and maintenance 6 mg/kg per day) vs low (loading 12.5 mg/kg and maintenance 3 mg/kg per day) caffeine citrate given 24 h prior to extubation | Frequency of apnea | High dose caffeine significantly decreased the frequency of apnea |
Steer et al[52] Australia | Prospective, randomized, blinded, controlled trial | 127 preterm infants less than 32 wk gestation | Three dosing regimens of caffeine citrate (3, 15 and 30 mg/kg) for peri-extubation management of ventilated preterm infants | Successful extubation defined as staying off ventilation for 7 d post-extubation | No statistically significant difference in the incidence of successful extubation however, infants in the two higher dose groups had statistically significantly less documented apnea |
Steer et al[53] Australia | Prospective, randomized, blinded, controlled trial | 234 preterm infants less than 30 wk gestation on mechanical ventilation | High (loading 80 mg/kg and maintenance 20 mg/kg per day) vs low (loading 20 mg/kg and maintenance 5 mg/kg per day) caffeine citrate given 24 h prior to extubation | Primary: Successful extubation of mechanically ventilated infants Secondary: Frequency of apnea | High dose caffeine significantly increased the chance for successful extubation, decreased the frequency of apnea and shortened the duration of respiratory support |
Shah et al[54] Singapore | Prospective, case control trial | Preterm infants less than 34 wk gestation | High (loading 20 mg/kg and maintenance 5 mg/kg per day) vs low (loading 10 mg/kg and maintenance 2.5 mg/kg per day) caffeine citrate | Primary: Frequency of apnea, desaturation, and shallow breathing Secondary: Side effect of caffeine, BPD, and ROP | High-dose caffeine significantly reduced episodes of apnea and shallow breathing without side effects |
Gray et al[125] Australia | Prospective, randomized, blinded, controlled trial | 287 preterm infants less than 30 wk gestation exhibit AOP or require mechanical ventilation | Loading dose of 40 mg/kg followed by two maintenance doses of either 20 or 5 mg/kg per day | Primary: Cognitive development at 1 yr of age on the Griffiths Mental Development Scales Secondary: Neonatal morbidity, death and disability, temperament at 1 yr and behavior at 2 yr of age | High maintenance dose was associated with borderline benefit in cognitive outcome without increasing morbidity, temperament or behavior disorders |
Mohammed et al[55] Egypt | Prospective, randomized, blinded, controlled trial | 120 preterm infants less than 32 wk gestation exhibit AOP or require mechanical ventilation | High (loading 40 mg/kg and maintenance 20 mg/kg per day) vs low (loading 20 mg/kg and maintenance 10 mg/kg per day) caffeine citrate | Primary: Successful extubation of mechanically ventilated infants Secondary: Frequency and documented days of apnea | High dose caffeine significantly increased the chance for successful extubation, decreased frequency of apnea |
- Citation: Abdel-Hady H, Nasef N, Shabaan AE, Nour I. Caffeine therapy in preterm infants. World J Clin Pediatr 2015; 4(4): 81-93
- URL: https://www.wjgnet.com/2219-2808/full/v4/i4/81.htm
- DOI: https://dx.doi.org/10.5409/wjcp.v4.i4.81