Abstract：Objective To explore the clinical effect and safety of Caffeine Citrate at different maintenance doses in the treatment of apnea in premature infants.Methods A total of 110 premature infants with apnea in Neonatal Intensive Care Unit of Yueyang Maternal and Child Health Hospital from January 2018 to December 2019 were selected as the research subjects.According to the random number table method,they were divided into an experimental group and a control group,with 55 cases in each group.Both groups were given a loading dose of Caffeine Citrate with 20 mg/kg for the first occurrence of apnea.After 24 hours,the experimental group was given maintenance dose of high-dose Caffeine Citrate with 10 mg/(kg·d),and the control group was given maintenance dose of low-dose Caffeine Citrate with 5 mg/(kg·d).The duration of apnea,the onset frequency of apnea,the success rate of withdrawal,the duration of invasive ventilator,the duration of non-invasive ventilator,the duration of oxygen therapy,the total length of hospital stay,and the incidence of various short-term complications were compared between the two groups.Results The frequency and duration of apnea in the experimental group were lower than those in the control group,and the success rate of withdrawal was higher than that in the control group,the differences were statistically significant(P＜0.05).There were no significant differences in invasive ventilator use time,non-invasive ventilator use time,oxygen therapy duration and total hospital stay between the two groups(P＞0.05).There were no significant differences in the incidence rates of short-term complications(bronchopulmonary dysplasia,necrotizing enterocolitis,ductus arteriosus opening)between the two groups(P＞0.05).Conclusion Compared with low-dose of Caffeine Citrate,high-dose of Caffeine Citrate can effectively reduce the frequency of apnea attacks in children,shorten the duration of apnea,improve the success rate of withdrawal,and does not increase the incidence of complications.It has better efficacy and is worthy of promotion and application.
秦素芳;廖海蓉;李鸿鸣;许德权. 不同剂量枸橼酸咖啡因治疗早产儿呼吸暂停的临床效果及安全性[J]. 中国当代医药, 2021, 28(17): 35-38转51.
QIN Su-fang; LIAO Hai-rong; LI Hong-ming ;XU De-quan. Clinical effect and safety of different doses of Caffeine Citrate in the treatment of apnea in premature infants. 中国当代医药, 2021, 28(17): 35-38转51.
Janvier A，Khairy M，Kokkotis A，et al.Apnea is associated with neurodevelopmental impairment in very low birth weight infants[J].Perinatol，2004，24（12）：763-768.
[2]
Pillekamp F，Hermann C，Keller T，et al.Factors influencing apnea and bradycardia of prematurity-implications for neurodevelopment[J].Neonatology，2007，91（3）：155-161.
[3]
Goussakov I，Synowiec S，Yarnykh V，et al.Immediate and delayed decrease of long term potentiation and memory deficits after neonatal intermittent hypoxia[J].Int J Dev Neurosci，2019，74：27-37.
[4]
Dobson NR，Hunt CE.Pharmacology Review：Caffeine Use in Neonates：Indications，Pharmacokinetics，Clinical Effects，Outcomes[J].Neoreviews，2013，14（11）：e540-e550.
[5]
Shivakumar M，Jayashree P，Najih M，et al.Comparative Efficacy and Safety of Caffeine and Aminophylline for Apnea of Prematurity in Preterm（≤34 weeks）Neonates：A Randomized Controlled Trial[J].Indian Pediatr，2017，54（4）：279-283.
[6]
Eichenwald EC，Committee on Fetus and Newborn，American Academy of Pediatrics.Apnea of Prematurity[J].Pediatrics，2016，137（1）：2015-3757.
[7]
邵肖梅，叶鸿瑁.实用新生儿学[M].5 版.北京：人民卫生出版社，2011：596-695.
[8]
Hall NJ，Eaton S，Pierro A.Royal Australasia of Surgeons Guest Lecture.Necrotizing enterocolitis：prevention，treatment，and outcome[J].J Pediatr Surg，2013，48（12）：2359-2367.
[9]
Hellstrm A，Smith LE，Dammann O.Retinopathy of prematurity[J].Lancet，2013，382（9902）：1445-1457.
[10]
Morton SU，Smith VC.Treatment options for apnoea of prematurity[J].Arch Dis Child Fetal Neonatal Ed，2016，101（4）：F352-F356.
[11]
Henderson-Smart DJ.The effect of gestational age on the incidence and duration of recurrent apnoea in newborn babies[J].Aust Paediatr J，1981，17（4）：273-276.
Tracy MB，Klimek J，Hinder M，et al.Does caffeine impair cerebral oxygenation and blood flow velocity in preterm infants?[J].Acta Paediatr，2010，99（9）：1319-1323.
[15]
Henderson -Smart DJ，Davis PG.Prophylactic methylxanthines for endotracheal extubation in preterm infants[J].Cochrane Database Syst Rev，2010，8（12）：139.
[16]
Francart SJ，Allen MK，Stegall-Zanation J.Apena of prematurity：caffeine does optimaization[J].Pediatr Pharmcol Ther，2013，18（1）：45-52.
[17]
Mohammed S，Nour I，Shabaan AE，et al.High versus lowdose caffeine for apnea of prematurity：a randomized controlled trial[J].Eur J Pediatrics，2015，174（7）：949-956.
[18]
Mcpherson C，Neil JJ，Tjoeng TH，et al.A pilot randomized trial of high-dose caffeine therapy in preterm infants[J].Pediatr Res，2015，78（2）：198-204.
[19]
Chen J，Jin L，Chen X.Efficacy and Safety of Different Maintenance Doses of Caffeine Citrate for Treatment of Apnea in Premature Infants：A Systematic Review and Meta-Analysis[J].Biomed Res Int，2018，2018：1-11.
[20]
Mohammed S，Nour I，Shabaan AE，et al.High versus lowdose caffeine for apnea of prematurity：a randomized controlled trial[J].Eur J Pediatr，2015，174（7）：949-956.
京公网安备 11010502046607号