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Caffeine Treatment for Prostaglandin E1-Induced Apnea Prevention in Congenital Heart Disease Neonates: A Randomized

Ladan Salamati1, Bahar Dehghan1, Mohammad Reza Sabri1

  • 1Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

Critical Care Research and Practice
|May 20, 2025
PubMed

Insights

Caffeine therapy did not significantly reduce apnea in neonates with congenital heart disease (CHD) receiving Prostaglandin E1 (PGE1). Further research is needed to confirm caffeine

Area of Science:

  • Neonatal Medicine
  • Pediatric Cardiology
  • Clinical Pharmacology

Background:

  • Congenital heart diseases (CHDs) are structural heart abnormalities.
  • Prostaglandin E1 (PGE1) is crucial for maintaining ductus arteriosus patency in neonates with ductal-dependent lesions.
  • PGE1 use is associated with an increased risk of apnea in neonates.

Purpose of the Study:

  • To investigate the efficacy of caffeine therapy in preventing or reducing apnea in neonates with CHD treated with PGE1.
  • To assess the impact of caffeine on the side effects of PGE1 infusion in this vulnerable population.

Main Methods:

  • A single-blinded randomized clinical trial involving 51 neonates with CHD.
  • Participants were assigned to receive either PGE1 alone or PGE1 plus caffeine.
  • Apnea prevalence, clinical data, and PGE1 side effects were systematically recorded and analyzed.

Main Results:

  • The study included 51 neonates (25 in the PGE1+caffeine group, 26 in the PGE1 group).
  • Apnea prevalence was 20% in the caffeine group versus 42% in the PGE1-only group (p=0.086), a difference that did not reach statistical significance.
  • Neonatal age was a significant factor influencing the time to apnea in the caffeine group (HR=0.87, p=0.04).

Conclusions:

  • Current findings do not provide conclusive evidence that caffeine therapy effectively reduces PGE1-induced apnea in neonates with CHD.
  • A larger, robust randomized controlled trial is warranted to definitively establish the role of caffeine in mitigating PGE1-associated apnea.

Keywords:
apneacaffeinecongenital heart diseaseneonatesprostaglandin

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