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INTRODUCTION: Prophylactic caffeine therapy, reduces the frequency of apnea in premature babies. Moreover, its effect has been well established in reducing the intermittent hypoxemia, and the need for additional ventilator support of infants with a birthweight of 1.250 g and respiratory distress. METHODS: Sixty-eight infants with birthweight of 1.250 to 2.000 g with respiratory distress and born at 32-34 GA and intubated with the indication of respiratory distress who also needed nasal ventilation for at least 48 hours were included in this prospective randomized controlled study, starting from birth one group received prophylactic caffeine citrate at loading dose of 20 mg/kg, and maintenance dose of 5 mg/kg in addition to respiratory support, long term neurological and developmental outcomes were recorded with Bayley-II. RESULTS: There was no difference in weight or gestational age at birth between the groups. Also, the groups were smilar in respiratory states. The caffeine group, was associated with a significant reduction in intubation requirement within the first 72 hr and shorter duration of mechanical and nasal ventilation, while there was no difference between the groups in total duration of oxygen therapy, and frequency of apneic episodes (respectively p=0.03, p=0.00, p=0.02, p>0.05). Any differences were not detected in terms of prematurity morbidities (p>0.05). Any significant intergroup differences were not detected as for PDA, NEC, IVC, laser-requiring ROP, and BPD (p>0.05). While the study was continuing regarding long-term neurodevelopmental outcomes Bayley neurodevelopmental tests were applied to 15 infants in the caffeine and 18 infants in the caffeine group at 12. and 18. months, and test results were csimilar in both groups (p>0.05). DISCUSSION AND CONCLUSION: The prophylactic use of caffeine in older preterm babies with respiratory distress, have short term benefits as lesser requirement for ntubation within the first 72 hours and decreased duration of ventilatory support without any advers side effects. Therefore if symptoms of respiratory distress are seen in preterm babies with a birthweight of >1.250 g, then initiation of prophylactic treatment may be considered. Larger scale randomized kontrollü studies are needed regarding this issue.

Objective: Today, the survival rate of low-birth-weight infants has increased thanks to supportive care. However, various permanent health problems, especially neurodevelopmental retardation, can be seen in these infants. This study investigates the risk factors associated with neurodevelopmental retardation, especially hypocarbia, in this patient group. Methods: All patients who were hospitalized in our neonatal ıntensive care unit between January 1 and December 31, 2016, with a gestational age of less than 32 weeks, without congenital anomalies, and who came for regular follow-up were included in this study. Demographic, clinical and laboratory data were obtained retrospectively from file records. The neurodevelopment of the patients was evaluated between 18 and 24 months with the Bayley Scales of Infants and Toddler Development, Second Edition (Bayley-II).The demographic, clinical and laboratory parameters of the patients with and without neurodevelopmental retardation were compared. Results: Neurodevelopmental retardation was observed in 9 (16.1%) of the 56 patients included in the study. No neurodevelopmental retardation was detected due to cerebral palsy, hearing impairment or visual impairment. When the patient groups with and without neurodevelopmental retardation were compared in terms of demographic, clinical and laboratory parameters, birth weight and first and fifth-minute Apgar scores were lower in patients with neurodevelopmental retardation, while mechanical ventilation requirement, reintubation, convulsion, patent ductus arteriosus treatment, hypotension, bronchopulmonary dysplasia, asphyxia, hyperglycemia and hypocarbia rate were higher (p