Abstract:

Objective To compare the efficacy and safety of two maintenance methods of caffeine for the prevention of apnea of prematurity（AOP）so as to simplify the maintenance method of caffeine. Methods Totally， 310 preterm infants with gestational age of less than 32 weeks，birth weight of less than 1 500 g，and beginning use of caffeine within 3 days after birth admitted from January 2018 to December 2020 were enrolled as subjects in the study. The subjects were divided into two groups：fixed dose maintenance group［birthweight × 10 mg/（kg·d）， n = 166］and modified maintenance dose group（variant birthweight × 5 mg/kg，n = 144）. The prevention effect， complications，adverse reactions and clinical outcomes were compared between the two groups. Results The inci⁃ dence rate of apnea，the rate of additionally increasing caffeine dose and the rate of improving respiratory support in the fixed maintenance dose group were all significantly lower than those in the modified maintenance dose group （P < 0.05）. However，there were no significant differences in the incidence of AOP，duration of ventilation，hospi⁃ tal stay，duration of apnea and birth weight recovery between the two groups（P > 0.05）. There were no significant differences either in the rates of necrotizing enterocolitis，broncho pulmonary dysplasia，intraventricular hemor⁃ rhage，late⁃onset sepsis，tachycardia，feeding intolerance，retinopathy of prematurity and patent ductus arteriosus （P > 0.05）. Conclusions The maintenance with fixed dose（birthweight × 10 mg/kg）is an effective way in pre⁃ venting apnea of prematurity. It may reduce the clinical workload and improve the patient safety from the frequent changes of the dose of caffeine.

Key words:

caffeine, apnea of prematurity, maintenance dose, efficacy, safety