Related Experiment Video
Updated: Apr 17, 2026
Polygraphic Recording Procedure for Measuring Sleep in Mice
Published on: January 25, 2016
High versus low-dose caffeine for apnea of prematurity: a randomized controlled trial
Sameh Mohammed1, Islam Nour, Abd Elazeez Shabaan
1Neonatal Intensive Care Unit, Mansoura University Children's Hospital, Mansoura, Egypt, dr_sameh5550@yahoo.com.
Insights
Higher doses of caffeine citrate effectively treat apnea of prematurity (AOP) in preterm infants. This approach reduces extubation failure and apnea frequency without significant adverse effects.
Area of Science:
- Neonatal Medicine
- Pharmacology
Background:
- Caffeine therapy is established for apnea of prematurity (AOP).
- Optimal caffeine dosing in preterm infants remains under investigation.
- Previous studies have not extensively explored higher doses of caffeine citrate.
Purpose of the Study:
- To compare the efficacy and safety of high-dose versus low-dose caffeine citrate for AOP in preterm infants.
- To evaluate the impact of different caffeine doses on successful extubation from mechanical ventilation.
Main Methods:
- A double-blind, randomized controlled trial involving 120 preterm infants (<32 weeks gestation) with AOP.
- Comparison of high-dose (40 mg/kg/day loading, 20 mg/kg/day maintenance) versus low-dose (20 mg/kg/day loading, 10 mg/kg/day maintenance) caffeine citrate.
- Assessment of extubation failure, apnea frequency, and adverse events.
Main Results:
- High-dose caffeine significantly reduced extubation failure (p<0.05).
- High-dose caffeine led to a significant decrease in apnea frequency (p<0.001) and days of documented apnea (p<0.001).
- Increased episodes of tachycardia were observed with high-dose caffeine (p<0.05), but this did not significantly impact decisions to withhold treatment.
Conclusions:
- Higher doses of caffeine citrate may improve outcomes for preterm infants with AOP.
- Increased caffeine dosage can decrease extubation failure and apnea frequency.
- The higher dose regimen was well-tolerated and did not lead to significant adverse effects impacting clinical management.
Unlabelled:
The optimum caffeine dose in preterm infants has not been well investigated. We aimed to compare the efficacy and safety of high versus low-dose caffeine citrate on apnea of prematurity (AOP) and successful extubation of preterm infants from mechanical ventilation. We compared high-dose (loading 40 mg/kg/day and maintenance of 20 mg/kg/day) versus low-dose (loading 20 mg/kg/day and maintenance of 10 mg/kg/day) caffeine citrate in preterm infants <32 weeks gestation, presented with AOP within the first 10 days of life. A total of 120 neonates (60 in each group) were enrolled. High-dose caffeine was associated with a significant reduction in extubation failure in mechanically ventilated preterm infants (p<0.05), the frequency of apnea (p<0.001), and days of documented apnea (p<0.001). High-dose caffeine was associated with significant increase in episodes of tachycardia (p<0.05) without a significant impact on physician decision to withhold caffeine.
Conclusion:
The use of higher, than current standard, dose of caffeine may decrease the chance of extubation failure in mechanically ventilated preterm infants and frequency of AOP without significant side effects.
What Is Known:
• Caffeine therapy for treatment of apnea of prematurity has been well established over the past few years. The optimal loading and maintenance dose of caffeine in preterm infants is not well-studied. What is New: • This double blind randomized controlled trial demonstrated that using a higher, than current standard, loading and maintenance doses of caffeine for treatment of apnea in preterm infants is well tolerated and significantly decrease the frequency of apnea.
