Caffeine therapy for apnea of prematurity.

@article{Schmidt2006CaffeineTF,
  title={Caffeine therapy for apnea of prematurity.},
  author={Barbara Schmidt and Robin S. Roberts and Peter Graham Davis and Lex William Doyle and Keith James Barrington and Arne Ohlsson and Alfonso J Solimano and Win Tin},
  journal={The New England journal of medicine},
  year={2006},
  volume={354 20},
  pages={
          2112-21
        }
}
BACKGROUND Methylxanthines reduce the frequency of apnea of prematurity and the need for mechanical ventilation during the first seven days of therapy. [...] Key Method We evaluated the short-term outcomes before the first discharge home. Expand
Long-term effects of caffeine therapy for apnea of prematurity.
TLDR
Caffeine therapy for apnea of prematurity improves the rate of survival without neurodevelopmental disability at 18 to 21 months in infants with very low birth weight. Expand
Duration of Caffeine for Apnea of Prematurity—A Randomized Controlled Trial
TLDR
Mandatorily continuing caffeine therapy up to 34 wk PMA in select preterm groups does not seem to decrease risk of recurrence of apnea, and larger trials that specifically study extremely preterm infants are required to make robust recommendations on when to stop therapy. Expand
Apnea of prematurity: caffeine dose optimization.
TLDR
In neonates less than 28 weeks gestational age, doses of caffeine citrate greater than 7.9 mg/kg/day are safe and are associated with a decreased need for clinical interventions. Expand
Caffeine for Apnea of Prematurity: A Neonatal Success Story
TLDR
Caffeine for Apnea of Prematurity was an international, multicenter, placebo-controlled randomized trial designed to determine whether survival without neurodevelopmental disability at a corrected age of 18 months is improved if apnea of prematurity is managed without methylxanthines in infants at a high risk of apneic attacks. Expand
Caffeine Treatment for Apnea of Prematurity and the Influence on Dose-Dependent Postnatal Weight Gain Observed Over 15 Years
TLDR
While a variety of measures are optimized to promote postnatal weight gain of premature infants close to an ideal intrauterine growth curve, not paying sufficient attention to one of the most widely used catabolic agents in neonatology is questionable and warrants vigilance. Expand
Association of early versus late caffeine administration on neonatal outcomes in very preterm neonates
TLDR
In this third large-scale observational study of the Canadian Neonatal Network, Lodha et al. retrospectively investigated the effect of early versus late initiation of caffeine therapy on neonatal short-term outcomes of very preterm infants. Expand
Apnoea of prematurity - discontinuation of methylxanthines in a resource-limited setting
TLDR
The main reason for discontinuing caffeine early was the baby’s ability to feed satisfactorily, a demonstration of physiological maturity, and as feeding behaviours mature significantly between 33 and 36 weeks, the ability toFeed may be a good indication that caffeine therapy can be stopped. Expand
Early caffeine therapy for prevention of bronchopulmonary dysplasia in preterm infants
  • Dalal Taha, S. Kirkby, +4 authors Z. Aghai
  • Medicine
  • The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
  • 2014
TLDR
Early commencement of caffeine was associated with improvement in survival without BPD in preterm infants and an increase in the risk of nectrotizing enterocolits (NEC) with early caffeine use. Expand
Association of early caffeine administration and neonatal outcomes in very preterm neonates.
TLDR
In very preterm neonates, early (prophylactic) caffeine use was associated with a reduction in the rates of death or bronchopulmonary dysplasia and patent ductus arteriosus. Expand
Caffeine versus aminophylline in combination with oxygen therapy for apnea of prematurity: A retrospective cohort study
TLDR
Caffeine performs better than aminophylline in the treatment of premature infants with apnea under different conditions of O2 delivery and decreases the incidence of recurrent apnea events and complications in the investigated population. Expand
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References

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Methylxanthine Therapy for Apnea of Prematurity: Evaluation of Treatment Benefits and Risks at Age 5 Years in the International Caffeine for Apnea of Prematurity (CAP) Trial
TLDR
The main outcome at 5 years will be a composite of death or survival with severe disability in at least one of six domains: cognition, neuromotor function, vision, hearing, behavior, and general health. Expand
Methylxanthine treatment for apnea in preterm infants.
TLDR
Methylxanthines are effective in reducing the number of apneic attacks and the use of mechanical ventilation in the two to seven days after starting treatment, and caffeine would be the preferred drug. Expand
Effect of Caffeine on Oxygen Consumption and Metabolic Rate in Very Low Birth Weight Infants With Idiopathic Apnea
TLDR
Long-term administration of caffeine in preterm infants is associated with an increase in oxygen consumption and with a reduction of weight gain, which may have implications for clinical practice as nutritional regimens need to be adjusted during this therapy. Expand
The Natural History of the Appearance of Apnea of Prematurity
TLDR
Reduced respiratory drive, as demonstrated by airway occlusion pressures, was associated with more frequent apnea and was evident at the first occlusions study, which frequently preceded the first significant apnea. Expand
Metabolic and respiratory effects of theophylline in the preterm infant
TLDR
After theophylline treatment, preterm infants had faster respiration, lower transcutaneous CO2, and improved static respiratory compliance without increased physical activity, which could be detrimental to the growth of the preterm infant. Expand
Doxapram treatment for apnea in preterm infants.
TLDR
Although intravenous Doxapram might reduce apnea within the first 48 hours of treatment, there are insufficient data to evaluate the precision of this result or to assess potential adverse effects. Expand
Oxygen consumption in apneic premature infants after low‐dose theophylline
TLDR
This dose of theophylline is effective in idiopathic apnea of prematurity and acts as a metabolic stimulant in the premature infant and increases in . Expand
Doxapram treatment for apnea in preterm infants.
TLDR
Although intravenous doxapram might reduce apnea within the first 48 hours of treatment, there are insufficient data to evaluate the precision of this result or to assess potential adverse effects. Expand
Effect of aminophylline on respiratory center activity and metabolic rate in premature infants with idiopathic apnea.
TLDR
Findings support the hypothesis that apnea in premature infants is related to an immature respiratory center characterized by a decreased output, and Aminophylline probably increases respiratory center output by lowering the threshold of the central chemorecepter to CO2. Expand
Apnea frequently persists beyond term gestation in infants delivered at 24 to 28 weeks.
TLDR
Apnea of prematurity frequently persists beyond term gestation in infants delivered at 24 to 28 weeks' gestational age and these persistent apnea and/or bradycardia events may contribute to prolonged hospitalization. Expand
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