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.
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.
Authors: Dalal Taha; Sharon Kirkby; Ursula Nawab; Kevin C Dysart; Linda Genen; Jay S Greenspan; Zubair H Aghai Journal: J Matern Fetal Neonatal Med Date: 2014-02-17
Authors: Abhay Lodha; Mary Seshia; Douglas D McMillan; Keith Barrington; Junmin Yang; Shoo K Lee; Prakesh S Shah Journal: JAMA Pediatr Date: 2015-01 Impact factor: 16.193
Authors: Barbara Schmidt; Robin S Roberts; Peter Davis; Lex W Doyle; Keith J Barrington; Arne Ohlsson; Alfonso Solimano; Win Tin Journal: N Engl J Med Date: 2006-05-18 Impact factor: 91.245
Authors: Barbara Schmidt; Robin S Roberts; Peter Davis; Lex W Doyle; Keith J Barrington; Arne Ohlsson; Alfonso Solimano; Win Tin Journal: N Engl J Med Date: 2007-11-08 Impact factor: 91.245
Authors: Nicole R Dobson; Ravi M Patel; P Brian Smith; Devon R Kuehn; Jennifer Clark; Shilpa Vyas-Read; Amy Herring; Matthew M Laughon; David Carlton; Carl E Hunt Journal: J Pediatr Date: 2014-01-23 Impact factor: 4.406
Authors: P A Steer; V J Flenady; A Shearman; T C Lee; D I Tudehope; B G Charles Journal: J Paediatr Child Health Date: 2003 Sep-Oct Impact factor: 1.954
Authors: Xue-Fei Zhang; Xiao-Ri He; Wen Li; Tao Wang; Jin-Tao Hu; Qing-Yi Dong; Ping-Yang Chen Journal: Zhongguo Dang Dai Er Ke Za Zhi Date: 2021-12-15