High versus standard dose caffeine for apnoea: a systematic review
Vliegenthart R, Miedema M, Hutten GJ, van Kaam AH, Onland W
Archives of disease in childhood. Fetal and neonatal edition · 36 citas
Etiquetas de revisión
Financiación no declaradaDatos neutrales que nuestra revisión registró sobre cómo se hizo este estudio. Describen el método, nunca si nos gusta el resultado.
Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2018-02-07 · Arch Dis Child Fetal Neonatal Ed · vol. 103 · número 6 · págs. F523–F529
- Editorial
- BMJ
- Citado
- 50 citas · más que el 82% de estudios similares · 1.6× el promedio de su campo
- Referencias
- 38 trabajos
- Acceso
- Acceso abierto (copia en repositorio) · OTHER-OA
- Áreas de investigación
- Neonatal Respiratory Health Research · Neuroscience of respiration and sleep · Infant Development and Preterm Care
- Palabras clave
- Caffeine, Medicine, Bronchopulmonary dysplasia, Placebo, Randomized controlled trial, Dose, Meta-analysis, Regimen, Pediatrics, Theophylline, Systematic review, Gestational age, MEDLINE, Internal medicine, Pregnancy
- MeSH
- humans, bronchopulmonary dysplasia, apnea, infant, premature, diseases, caffeine, central nervous system stimulants, treatment outcome, infant mortality, dose-response relationship, drug, infant, infant, newborn, infant, premature
5 autores
- Roos J. S. Vliegenthart🇳🇱 · autor de correspondenciaAmsterdam UMC Location University of Amsterdam; Emma Kinderziekenhuis
- Martijn Miedema🇳🇱Amsterdam UMC Location University of Amsterdam; Emma Kinderziekenhuis
- Gerard J. Hutten🇳🇱Amsterdam UMC Location University of Amsterdam; Emma Kinderziekenhuis
- Anton H. van Kaam🇳🇱Amsterdam UMC Location University of Amsterdam; Emma Kinderziekenhuis
- Wes Onland🇳🇱Amsterdam UMC Location University of Amsterdam; Emma Kinderziekenhuis
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
Placebo-controlled trials have shown that caffeine is highly effective in treating apnoea of prematurity and reduces the risk of bronchopulmonary dysplasia (BPD) and neurodevelopmental impairment (NDI).
Objective
To identify, appraise and summarise studies investigating the modulating effect of different caffeine dosages.
Methods
A systematic review identified all randomised controlled trials (RCTs) comparing a high versus a standard caffeine treatment regimen in infants with a gestational age <32 weeks, by searching the main electronic databases and abstracts of the Pediatric Academic Societies. Studies comparing caffeine to placebo or theophylline only were excluded. Primary outcomes were BPD and mortality at 36 weeks postmenstrual age. Secondary key-outcome was neurodevelopmental outcome at 12 and 24 months corrected age. Meta-analysis was performed using RevMan 5.3.
Results
Six RCTs including 620 infants were identified. Meta-analysis showed a significant decrease in BPD, the combined outcome BPD or mortality, and failure to extubate in infants allocated to a higher caffeine dose. No differences were found in mortality alone and NDI. The quality of the outcome measures were deemed low to very low according to the Grading of Recommendations Assessment, Development and Evaluation guidelines.
Conclusions
Although this review suggests that administering a higher dose of caffeine might enhance its beneficial effect on death or BPD, firm recommendations on the optimal caffeine dose cannot be given due to the low level of evidence. A large RCT is urgently needed to confirm or refute these findings and determine the optimal dose of caffeine.
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