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Caffeine use in preterm neonates: national insights into Turkish NICU practices

Sezin Unal1, Serdar Beken2, Deniz Anuk Ince1

  • 1Division of Neonatology, Department of Pediatrics, Baskent University Faculty of Medicine, Ankara, Türkiye.

Frontiers in Pediatrics
|March 14, 2025
PubMed

Insights

Caffeine citrate use in premature infants varies significantly across neonatal intensive care units. This variability highlights the need for standardized national guidelines on prophylactic caffeine administration for preterm infants.

Area of Science:

  • Neonatology
  • Pharmacology
  • Pediatrics

Background:

  • Caffeine citrate is a key medication for preventing and treating apnea in premature infants.
  • International guidelines exist for caffeine prophylaxis in preterm infants, but national guidelines may differ.
  • Variability in current caffeine usage practices necessitates updated recommendations.

Purpose of the Study:

  • To describe the current practices and variability in caffeine citrate usage among neonatal intensive care units in Turkey.
  • To compare current practices with existing national and international guidelines.

Main Methods:

  • An online survey was distributed to neonatologists who are members of the Turkish Neonatology Society.
  • The survey collected data on prophylactic caffeine usage, including gestational age eligibility, timing, dosage, and duration of treatment.
  • Responses from 74 neonatal intensive care units were analyzed.

Main Results:

  • Prophylactic caffeine use varied by gestational age, with higher rates in earlier gestations (e.g., 98.6% for GA ≤27 6/7 weeks).
  • Dosing strategies and adjustment protocols showed considerable variation among units.
  • Significant intra-unit variations in caffeine administration were reported by over 30% of units with multiple physicians.

Conclusions:

  • There are significant differences in caffeine citrate usage characteristics both between and within neonatal intensive care units.
  • The observed variability underscores the urgent need for standardized national guidelines to ensure consistent and evidence-based care for preterm infants receiving caffeine prophylaxis.
Abstract

Keywords:
apnea of prematuritycaffeineguidelineneonatal intensive care unitpremature neonate

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