Dose-Dependent Effects of Caffeine Citrate in Preterm Infants: A Retrospective Analysis of Weight Gain and Cardiac Outcomes
Öz
Objective: A xanthine, caffeine citrate (CC), increases the metabolic rate with the release of catecholamine and affects weight gain in these patients in the first days. The cardiovascular system increases cardiac output and average arterial blood pressure by increasing heart rate, cardiac contractility, and stroke volume. This study investigated the effects of 5 and 10 mg/kg/day doses of CC on early postnatal weight gain velocity, discharge weight percentile, and cardiac function parameters in preterm infants.
Methods: Neonates who underwent CC-therapy between January 2020 and April 2023 and were ≤34 weeks gestation were included in this retrospective analysis. Twenty-three patients were given 5 mg/kg maintenance CC (group 1). Twenty-three patients were given 10 mg/kg maintenance CC (group 2). The groups were compared in terms of demographic data, complications of prematurity (RDS, BPD, NEC, IVH, ROP, PDA), type and duration of respiratory support, time to birth weight, time to total enteral nutrition, discharge weight percentile, and echocardiography (Echo) findings. Data for groups 1 and 2 were examined independently.
Results: The study included 46 neonates. Patients in group-1 (11± 6.1 day) achieved their birth weight for a statistically significant shorter period compared to group-2 (15± 5 day) (p <.05). The groups did not differ in any way regarding time to transition to full enteral nutrition, discharge weight percentile, discharge time, echocardiographic results, premature complication, type and duration of respiratory support.
Conclusion: Babies receiving CC at a dose of 5 mg/kg/day achieved their birth weight in a shorter time than those receiving 10 mg/kg/day. Both dosage regimens have similar safety in terms of side effects, weight gain after the first week, and cardiological aspects.
Anahtar Kelimeler
Kaynakça
- Montenegro BL, Amberson M, Veit L, Freiberger C, Dukhovny D, Rhein LM. Economics of home monitoring for apnea in late preterm infants. Respiratory care. 2017;62(1):42-48. google scholar
- Rostas SE, McPherson C. Caffeine Therapy in Preterm Infants: The Dose (and Timing) Make the Medicine. Neonatal Network. 2019;38(6) google scholar
- Long J-Y, Guo H-L, He X, Hu Y-H, Xia Y, Cheng R et al. Caffeine for the pharmacological treatment of apnea of prematurity in the NICU: dose selection conundrum, therapeutic drug monitoring and genetic factors. Frontiers in Pharmacology. 2021;12:681842. google scholar
- Huvanandana J, Thamrin C, McEwan AL, Hinder M, Tracy MB. Cardiovascular impact of intravenous caffeine in preterm infants. Acta Paediatrica. 2019;108(3):423-429. google scholar
- Philip RK, Ismail A, Murphy B, Mirza A, Quinn C, Dunworth M. Caffeine treatment for apnea of prematurity and the influence on dose-dependent postnatal weight gain observed over 15 years. Journal of Caffeine and Adenosine Research. 2018;8(3):99-106. google scholar
- Lopez L, Saurers DL, Barker PC, Cohen MS, Colan SD, Dwyer J et al. Guidelines for performing a comprehensive pediatric transthoracic echocardiogram: recommendations from the American Society of Echocardiography. Journal of the American Society of Echocardiography. 2024;37(2):119-170. google scholar
- Hussain I, Kumar M, Ali A, Naz F, Khan WA, Salat MS et al. Dose–Response Study of Caffeine on Postnatal Weight Gain in Premature Neonates—A Retrospective Cohort Study. Dose-Response. 2024;22(2):15593258241247185. google scholar
- Schmidt B, Roberts RS, Davis P, Doyle LW, Barrington KJ, Ohlssonet A et al. Long-term effects of caffeine therapy for apnea of prematurity. New England Journal of Medicine. 2007;357(19):1893-1902. google scholar
Ayrıntılar
Birincil Dil
İngilizce
Konular
Çocuk Kardiyolojisi, Yenidoğan
Bölüm
Araştırma Makalesi
Yazarlar
Cengizhan Ceylan
0000-0003-4164-9212
Türkiye
Hüseyin Yılmaz
0000-0002-9971-9669
Türkiye
Kadir Yümlü
0000-0002-1634-5084
Türkiye
Musa Silahlı
0000-0003-0944-7178
Türkiye
Yayımlanma Tarihi
12 Şubat 2026
Gönderilme Tarihi
23 Temmuz 2025
Kabul Tarihi
23 Eylül 2025
Yayımlandığı Sayı
Yıl 2025 Cilt: 25 Sayı: 4