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Review
. 2020 Dec;25(6):101178.
doi: 10.1016/j.siny.2020.101178. Epub 2020 Nov 1.

Caffeine for preterm infants: Fixed standard dose, adjustments for age or high dose?

Vivek Saroha  1 , Ravi Mangal Patel  2
Affiliations
Review

Caffeine for preterm infants: Fixed standard dose, adjustments for age or high dose?

Vivek Saroha et al. Semin Fetal Neonatal Med. 2020 Dec.

Abstract

Caffeine is an effective treatment for apnea of prematurity and has several important benefits, including decreasing respiratory morbidity and motor impairment. In this article, we focus on the dose of caffeine. We review the evidence regarding the efficacy and safety of standard caffeine dosing and alternative dosing approaches, including the use of high dose caffeine and routine dose adjustments for age. Current evidence suggests high dose caffeine may provide additional benefit in reducing the risk of bronchopulmonary dysplasia and extubation failure, but may also increase the risk of cerebellar hemorrhage and seizures. Increasing the standard caffeine citrate dose every 1-2 weeks to a goal dose of 8 mg per kilogram every 24 h may help maintain therapeutic effect. We conclude by highlighting the need for additional trials before high dose caffeine is routinely used.

Keywords: Apnea; Caffeine; Infant; Neonate; Pharmacokinetics; Preterm.

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Conflict of interest statement

CONFLICTS OF INTEREST STATEMENT: The authors have no conflicts of interest to declare.

References

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