Evaluation of Timing and Dosing of Caffeine Citrate in Preterm Neonates for the Prevention of Bronchopulmonary Dysplasia
| Autor: | Matthew Pellerite, Sudhir Sriram, Deborah S Bondi, Eleni E Shenk |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Pediatrics
medicine.medical_specialty business.industry Clinical Investigations medicine.disease 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine chemistry Bronchopulmonary dysplasia Caffeine citrate Neonatal outcomes 030225 pediatrics Pediatrics Perinatology and Child Health medicine Pharmacology (medical) 030212 general & internal medicine Dosing Caffeine business medicine.drug |
| Popis: | OBJECTIVE The aim of this study was to evaluate the timing and dosing of caffeine therapy in relation to the development of bronchopulmonary dysplasia (BPD). METHODS This was a single-center, retrospective cohort study comparing early (days of life 0–2) to late (day of life 3 or greater) caffeine initiation in extremely low birth weight neonates, with a secondary analysis of large (10 mg/kg/day) to small dose (5 mg/kg/day) caffeine. RESULTS There were 138 patients in the primary timing analysis. The early caffeine group had a lower incidence and reduced odds of the composite outcome of BPD or all-cause mortality, compared with the late caffeine group (64% vs. 88%, respectively; adjusted p < 0.05; adjusted OR 0.36 [95% CI 0.13–0.98]). No statistically significant difference was found between dosing groups (p = 0.29) in the primary outcome; however, there was a lower rate of patent ductus arteriosus requiring treatment (p = 0.05) and decreased likelihood of discharging home on oxygen (p = 0.02) in the large-dose group compared with the small-dose group. CONCLUSIONS Early caffeine initiation significantly decreased the incidence of BPD or all-cause mortality in extremely low birth weight neonates. Patients receiving large-dose caffeine had improved secondary outcomes, although no difference in BPD was noted. Further studies are needed to determine the optimal dosing of caffeine. |
| Databáze: | OpenAIRE |
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