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Periextubation caffeine in preterm neonates: A randomized dose response trial
- Source :
- Journal of Paediatrics and Child Health. 39:511-515
- Publication Year :
- 2003
- Publisher :
- Wiley, 2003.
-
Abstract
- Objective: To compare the effectiveness of three dosing regimens of caffeine for preterm infants in the periextubation period. Methods: A randomized double-blind clinical trial of three dosing regimens of caffeine citrate ( 3, 15 and 30 mg/kg) for periextubation management of ventilated preterm infants was undertaken. Infants born 48 h were eligible for the study. Caffeine citrate was given as a once daily dose for a period of 6 days commencing 24 h prior to a planned extubation, or within 6 h of an unplanned extubation. The primary outcome measure was extubation failure, defined as neonates who were unable to be extubated within 48 h of caffeine loading or who required reventilation or doxapram dose within 7 days of caffeine loading. Continuous recordings of oxygen saturation and heart rate were undertaken in a subgroup of enrolled infants. Results: A total of 127 babies were enrolled into the study ( 42, 40, 45, in the 3, 15, and 30 mg/kg groups, respectively). No statistically significant difference was demonstrated in the incidence of extubation failure between dosing groups ( 19, 10, and 11 infants in the 3, 15, and 30 mg/kg groups, respectively), however, infants in the two higher dose groups had statistically significantly less documented apnoea than the lowest dose group. Of the 37 neonates with continuous pulse oximetry recordings, those on higher doses of caffeine recorded a statistically significantly higher mean heart rate, oxygen saturations and less time with oxygen saturations < 85%. Conclusions: This trial indicated there were short-term benefits of decreased apnoea in the immediate periextubation period for ventilated infants born < 32 weeks gestation receiving higher doses of caffeine. Further studies with larger numbers of infants assessing longer-term outcomes are necessary to determine the optimal dosing regimen of caffeine in preterm infants.
- Subjects :
- Male
Apnea
Respiratory System Agents
law.invention
Double-Blind Method
Randomized controlled trial
law
Caffeine
Intensive care
Heart rate
Intubation, Intratracheal
medicine
Humans
Theophylline
Citrates
Dosing
Dose-Response Relationship, Drug
business.industry
Infant, Newborn
Doxapram
Drug Combinations
Caffeine citrate
Anesthesia
Pediatrics, Perinatology and Child Health
Central Nervous System Stimulants
Female
medicine.symptom
business
Ventilator Weaning
Infant, Premature
medicine.drug
Subjects
Details
- ISSN :
- 14401754 and 10344810
- Volume :
- 39
- Database :
- OpenAIRE
- Journal :
- Journal of Paediatrics and Child Health
- Accession number :
- edsair.doi.dedup.....b0f13dd4128e22ada0d5b761559b6c48