Related Experiment Video

Updated: Dec 31, 2025

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
19:15

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

Published on: August 25, 2014

87.4K

Confounding biases in studies on early- versus late-caffeine in preterm infants: a systematic review

Sandra Nylander Vujovic1, Chiara Nava2, Minna Johansson3

  • 1Skane University Hospital, Lund, Sweden.

Pediatric Research
|January 14, 2020
PubMed

Insights

Early caffeine administration in preterm infants may not reduce harm. Current evidence is insufficient to determine optimal timing, necessitating further research with long-term outcome focus.

Area of Science:

  • Neonatal Medicine
  • Pharmacology

Background:

  • Caffeine is used for apnea of prematurity and extubation in preterm infants.
  • Early caffeine initiation aims to reduce respiratory morbidity but may pose risks.
  • The optimal timing for caffeine administration remains unclear.

Purpose of the Study:

  • To systematically review evidence on whether early caffeine administration reduces morbidity and mortality in preterm infants.
  • To assess the impact of timing on infant outcomes.

Main Methods:

  • Systematic review of randomized controlled trials (RCTs) and cohort studies.
  • Literature search conducted in February 2019 without restrictions.
  • Included studies compared early versus late caffeine administration in infants born before 34 weeks gestation.

Main Results:

  • Included two RCTs and 14 cohort studies, most with high risk of bias.
  • Limited data available on long-term or patient-relevant outcomes.
  • No meta-analysis was possible due to study heterogeneity.

Conclusions:

  • Current evidence is insufficient to determine the optimal timing of caffeine administration.
  • Methodological limitations in cohort studies hinder definitive conclusions.
  • Further high-quality RCTs focusing on patient-relevant and long-term outcomes are needed.
Abstract

More Related Videos

Preterm EEG: A Multimodal Neurophysiological Protocol19:32

Preterm EEG: A Multimodal Neurophysiological Protocol

Published on: February 18, 2012

28.9K
Application of an Amplitude-integrated EEG Monitor Cerebral Function Monitor to Neonates05:58

Application of an Amplitude-integrated EEG Monitor Cerebral Function Monitor to Neonates

Published on: September 6, 2017

40.3K

Related Concept Videos

Experimental Designs01:16

Experimental Designs

An experimental design is a systematic process that allows researchers to evaluate the relationship between dependent and independent variables. There are three widely used types of experimental design - pre-experimental design, true experimental design, and quasi-experimental design. In pre-experimental design, the researcher compares the data before and after some interventions or treatments. The true-experimental design has more than one purposefully created group, a commonly measured...
16.5K
Blind Procedures02:07

Blind Procedures

Ideally, the people who observe and record the children’s behavior are unaware of who was assigned to the experimental or control group, in order to control for experimenter bias. Experimenter bias refers to the possibility that a researcher’s expectations might skew the results of the study. Remember, conducting an experiment requires a lot of planning, and the people involved in the research project have a vested interest in supporting their hypotheses. If the observers knew which...
12.8K
Bias in Epidemiological Studies01:29

Bias in Epidemiological Studies

Biases can arise at various stages of research, from study design and data collection to analysis and interpretation. Recognizing and addressing these biases is essential to ensure the validity and reliability of epidemiological findings.Broadly speaking, biases in epidemiology fall into three main categories: selection bias, information bias, and confounding. A more detailed description of possible biases is:  
1.2K
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
151
Factors Affecting Drug Response: Overview01:21

Factors Affecting Drug Response: Overview

When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...
2.8K
Chronopharmacokinetics: Circadian Rhythms and Influence on Drug Response01:15

Chronopharmacokinetics: Circadian Rhythms and Influence on Drug Response

Circadian rhythms are cyclic changes that are crucial in plasma drug concentrations. Various standard circadian parameters, including core body temperature, heart rate, and other cardiovascular factors, directly impact disease states and the therapeutic response to drug therapy.
The time of drug administration is an important factor to consider, as it can influence the toxic dose of a drug. For example, a study conducted by Prins et al. in 1997 examined the effects of the timing of...
303