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Caffeine treatment for bronchiolitis-related apnea in the pediatric intensive care unit

N Heuzé1, I Goyer2, F Porcheret3

  • 1CHU de Caen, Pediatric Intensive Care Unit, 14000, Caen, France; CHU de Caen, Pediatric Emergency Department, 14000, Caen, France; CH de Lisieux, Department of Pediatrics, 14000, Lisieux, France.

Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie
|November 29, 2019
PubMed

Insights

Caffeine treatment for bronchiolitis-related apnea (BRA) is common in pediatric intensive care units (PICUs), but this study found no significant clinical benefits or adverse effects. Further research is needed to determine optimal dosing for this population.

Area of Science:

  • Pediatric Critical Care Medicine
  • Neonatal and Developmental Medicine

Background:

  • Apnea is a frequent complication in infants diagnosed with bronchiolitis.
  • Current management guidelines for bronchiolitis-related apnea (BRA) are lacking.
  • Pediatric intensive care unit (PICU) practitioners often use caffeine, extrapolating from prematurity-related apnea protocols.

Purpose of the Study:

  • To describe BRA management practices within a specific PICU.
  • To determine the rate of caffeine prescription for BRA.
  • To explore the impact of caffeine on clinical outcomes in infants with BRA.

Main Methods:

  • A retrospective study was conducted in a university hospital PICU from 2009 to 2016.
  • Infants under one year old diagnosed with BRA were included.
  • Patients were categorized into a control group or a caffeine group based on treatment.

Main Results:

  • Out of 54 infants, 91% received caffeine treatment.
  • Ventilatory support was required for 93% of patients.
  • No significant differences in supportive care or PICU length of stay were observed between groups.
  • Caffeine administration was not linked to adverse events.

Conclusions:

  • Caffeine administration for BRA appears to be a localized standard practice.
  • The study was underpowered to demonstrate clinical benefits of caffeine for BRA.
  • Caffeine treatment showed no significant adverse effects in this cohort.
  • Optimal caffeine dosing for BRA in postterm infants requires further investigation.
Abstract

Keywords:
ApneaBronchiolitisCaffeineIntensive care

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