High Vs Low Dose Caffeine in Management of Apnea of Prematurity: A Single-Center Observational Study

Bhavya N Shroff; Poonam Singh; Amita U Surana; Ankur Chaudhari

doi:10.55489/njmr.150420251151

Authors

Bhavya N Shroff Department of Paediatrics, SMIMER Hospital and Medical College, Surat, Gujarat, India
Poonam Singh Department of Paediatrics, SMIMER Hospital and Medical College, Surat, Gujarat, India
Amita U Surana Department of Paediatrics, SMIMER Hospital and Medical College, Surat, Gujarat, India
Ankur Chaudhari Department of Paediatrics, SMIMER Hospital and Medical College, Surat, Gujarat, India

DOI:

https://doi.org/10.55489/njmr.150420251151

Keywords:

Prematurity Apnoea, Caffeine Dose, NICU Stay, Oxygenation, Extubation

Abstract

Background: Apnoea of prematurity is one of the leading causes of apnoea in preterm infants leading to hypoxia and deleterious neurodevelopmental outcomes. Caffeine has been used for management for apnea but the optimum dose has not been well investigated and a wide variety of the dose are under trials. The study aimed to compare the efficacy and safety of high and low dose caffeine.

Methodology: All the preterm infants with gestational age <34weeks and fulfilling our inclusion criteria were included in study. Babies born between the dates August 2023 to January 2024 were studied prospectively (Group A) and those between July 2022 to December 2022 were studied retrospectively (Group B). The infants included in Group A were given high dose caffeine (loading 40mg/kg/day and maintenance 20mg/kg/day) vs low dose caffeine was given to the Group B infants (loading dose 20mg/kg/day and maintenance 10mg/kg/day) and they were followed up based on their oxygen requirements, frequency of apnoea episodes, duration of NICU stay, duration of ventilation and successful extubation.

Results: High dose caffeine was found to be effective in reducing duration of oxygenation (p value 0.003) and duration of NICU stay (p value 0.03). There was no statistical significance found in frequency of apnea episodes, side effects and successful extubation between both the groups.

Conclusion: High dose is preferred as the duration of oxygenation and the hospital stay is shortened with no increase in side effects.

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