Caffeine therapy for apnea of prematurity.

@article{citeulike:1661066, abstract = {BACKGROUND: Methylxanthines reduce the frequency of apnea of prematurity and the need for mechanical ventilation during the first seven days of therapy. It is uncertain whether methylxanthines have other short- and long-term benefits or risks in infants with very low birth weight. METHODS: We randomly assigned 2006 infants with birth weights of 500 to 1250 g during the first 10 days of life to receive either caffeine or placebo, until drug therapy for apnea of prematurity was no longer needed. We evaluated the short-term outcomes before the first discharge home. RESULTS: Of 963 infants who were assigned to caffeine and who remained alive at a postmenstrual age of 36 weeks, 350 (36 percent) received supplemental oxygen, as did 447 of the 954 infants (47 percent) assigned to placebo (adjusted odds ratio, 0.63; 95 percent confidence interval, 0.52 to 0.76; P<0.001). Positive airway pressure was discontinued one week earlier in the infants assigned to caffeine (median postmenstrual age, 31.0 weeks; interquartile range, 29.4 to 33.0) than in the infants in the placebo group (median postmenstrual age, 32.0 weeks; interquartile range, 30.3 to 34.0; P<0.001). Caffeine reduced weight gain temporarily. The mean difference in weight gain between the group receiving caffeine and the group receiving placebo was greatest after two weeks (mean difference, -23 g; 95 percent confidence interval, -32 to -13; P<0.001). The rates of death, ultrasonographic signs of brain injury, and necrotizing enterocolitis did not differ significantly between the two groups. CONCLUSIONS: Caffeine therapy for apnea of prematurity reduces the rate of bronchopulmonary dysplasia in infants with very low birth weight. (ClinicalTrials.gov number, NCT00182312.).}, address = {Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont, Canada. schmidt@mcmaster.ca}, author = {Schmidt, B. and Roberts, R. S. and Davis, P. and Doyle, L. W. and Barrington, K. J. and Ohlsson, A. and Solimano, A. and Tin, W. and }, citeulike-article-id = {1661066}, doi = {http://dx.doi.org/10.1056/NEJMoa054065}, issn = {1533-4406}, journal = {N Engl J Med}, keywords = {nicu}, month = {May}, number = {20}, pages = {2112--2121}, posted-at = {2007-09-15 18:03:15}, priority = {4}, title = {Caffeine therapy for apnea of prematurity.}, url = {http://dx.doi.org/10.1056/NEJMoa054065}, volume = {354}, year = {2006} }

TY - JOUR ID - citeulike:1661066 L3 - citeulike-article-id:1661066 TI - Caffeine therapy for apnea of prematurity. JF - N Engl J Med VL - 354 IS - 20 SP - 2112 EP - 2121 AD - Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont, Canada. schmidt@mcmaster.ca SN - 1533-4406 N2 - BACKGROUND: Methylxanthines reduce the frequency of apnea of prematurity and the need for mechanical ventilation during the first seven days of therapy. It is uncertain whether methylxanthines have other short- and long-term benefits or risks in infants with very low birth weight. METHODS: We randomly assigned 2006 infants with birth weights of 500 to 1250 g during the first 10 days of life to receive either caffeine or placebo, until drug therapy for apnea of prematurity was no longer needed. We evaluated the short-term outcomes before the first discharge home. RESULTS: Of 963 infants who were assigned to caffeine and who remained alive at a postmenstrual age of 36 weeks, 350 (36 percent) received supplemental oxygen, as did 447 of the 954 infants (47 percent) assigned to placebo (adjusted odds ratio, 0.63; 95 percent confidence interval, 0.52 to 0.76; P<0.001). Positive airway pressure was discontinued one week earlier in the infants assigned to caffeine (median postmenstrual age, 31.0 weeks; interquartile range, 29.4 to 33.0) than in the infants in the placebo group (median postmenstrual age, 32.0 weeks; interquartile range, 30.3 to 34.0; P<0.001). Caffeine reduced weight gain temporarily. The mean difference in weight gain between the group receiving caffeine and the group receiving placebo was greatest after two weeks (mean difference, -23 g; 95 percent confidence interval, -32 to -13; P<0.001). The rates of death, ultrasonographic signs of brain injury, and necrotizing enterocolitis did not differ significantly between the two groups. CONCLUSIONS: Caffeine therapy for apnea of prematurity reduces the rate of bronchopulmonary dysplasia in infants with very low birth weight. (ClinicalTrials.gov number, NCT00182312.). KW - nicu AU - Schmidt, B AU - Roberts, RS AU - Davis, P AU - Doyle, LW AU - Barrington, KJ AU - Ohlsson, A AU - Solimano, A AU - Tin, W PY - 2006/05/18/ UR - http://dx.doi.org/10.1056/NEJMoa054065 ER -