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Serum caffeine concentrations in preterm infants: a retrospective study.
Masashiro Sugino1, Toru Kuboi2, Yuta Noguchi3
1Division of Neonatology, NHO Shikoku Medical Center for Children and Adults, 2-1-1 Senyu Cho, Zentsuji City, Kagawa, 765-8507, Japan. rmasashirod@yahoo.co.jp.
Scientific Reports
|June 26, 2023
Summary
Therapeutic drug monitoring for caffeine in preterm infants is usually not needed. However, doses of 8 mg/kg/day or higher may lead to toxic caffeine levels, requiring further study on neurological effects.
Area of Science:
- Neonatal Medicine
- Pharmacology
Background:
- Therapeutic drug monitoring for caffeine in apnea of prematurity is often deemed unnecessary due to typically low serum concentrations.
- Despite this, some preterm infants have experienced caffeine toxicity.
Purpose of the Study:
- To evaluate the relationship between caffeine maintenance dose and serum concentrations in preterm infants.
- To identify the specific maintenance dose associated with potentially toxic serum caffeine levels.
Main Methods:
- A retrospective observational study involving 24 preterm infants treated with caffeine citrate for apnea of prematurity.
- Analysis of 272 serum samples to correlate caffeine dose with serum concentrations.
Main Results:
- A significant positive correlation was observed between caffeine dose and serum caffeine concentrations (r=0.72, p<0.05).
- Approximately 15% of infants receiving doses of 8 mg/kg/day or higher had serum caffeine concentrations exceeding suggested toxic levels.
Conclusions:
- Caffeine doses of 8 mg/kg/day or more increase the risk of reaching suggested toxic serum caffeine levels in preterm infants.
- The neurological impact of these elevated caffeine concentrations requires further investigation, including long-term neurodevelopmental follow-up.
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