Prophylactic Effect of Venous Caffeine on Apnea in the Very Preterm Infants

Introduction: One of the most common problems in newborns is apnea of prematurity.Given the importance of preventing apnea in very premature infants, the present study was designed and conducted to investigate the preventive effect of caffeine on reducing the frequency of apnea events in very premature infants.Methods: This randomized, double-blind, controlled clinical trial was conducted on premature infants hospitalized in the neonatal intensive care unit of Shahid Motahari Hospital in Urmia.Infants were randomly divided into two intervention and control groups.The intervention group received intravenous caffeine at an initial dose of 20 mg/kg and a maintenance dose of 5 mg/kg for 14 days.In contrast, the control group received an equal volume of normal saline intravenously for the same period.Apnea events, cyanosis attacks, and bradycardia were recorded by the researchers in a standard checklist.Results: Of the 50 infants in each group, 2% of the caffeine and 4% of the control group required prolonged oxygen therapy, respectively.Also, 6% of the caffeine group and 4% of the control group experienced intraventricular hemorrhage.In addition, 4% of the caffeine group and 2% of the control group required surgery to close the patent ductus arteriosus, and 14% of the caffeine group and 18% of the control group experienced apneic events.However, there was no statistically significant difference between the two groups regarding the incidence of apneic events (P = 0.58).Ultimately, 20% of the caffeine group and 14% of the control group died.Conclusions: Although the findings of the present study were not statistically significant, they indicate a decrease in the frequency of apnea events in the group of premature infants receiving caffeine compared to the control group.