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Updated: Feb 14, 2026
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Caffeine Extraction, Enzymatic Activity and Gene Expression of Caffeine Synthase from Plant Cell Suspensions
Published on: October 2, 2018
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High versus standard dose caffeine for apnoea: a systematic review
Roos Vliegenthart1, Martijn Miedema1, Gerard J Hutten1
1Department of Neonatology, Emma Children's Hospital, Academic Medical Center, Amsterdam, Noord-Holland, The Netherlands.
Archives of Disease in Childhood. Fetal and Neonatal Edition
|February 14, 2018
Summary
Higher caffeine doses may reduce bronchopulmonary dysplasia (BPD) and mortality in premature infants. However, more research is needed to confirm optimal dosing due to low evidence quality.
Area of Science:
- Neonatal medicine
- Pharmacology
- Clinical trials
Background:
- Caffeine effectively treats apnoea of prematurity.
- Caffeine reduces risks of bronchopulmonary dysplasia (BPD) and neurodevelopmental impairment (NDI).
Purpose of the Study:
- To evaluate the impact of different caffeine dosages on infant outcomes.
- To summarize evidence from randomized controlled trials (RCTs) on caffeine treatment regimens.
Main Methods:
- Systematic review of RCTs comparing high vs. standard caffeine doses in infants with gestational age <32 weeks.
- Exclusion of studies comparing caffeine to placebo or theophylline only.
- Meta-analysis of primary outcomes: BPD and mortality at 36 weeks postmenstrual age; secondary outcome: neurodevelopmental outcome at corrected ages.
Main Results:
- Six RCTs with 620 infants were analyzed.
- Higher caffeine doses significantly decreased BPD, BPD or mortality, and extubation failure.
- No significant differences in mortality or NDI; outcome measure quality was low to very low.
Conclusions:
- Higher caffeine doses may improve outcomes for BPD or mortality.
- Firm recommendations on optimal caffeine dosage cannot be made due to low evidence.
- A large RCT is required to confirm findings and establish optimal caffeine dosage.
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