Caffeine for Persistent Intermittent Hypoxia in Newborns With and Without Chronic Lung Disease.

IF 2.3 3区医学 Q1 PEDIATRICS

Pediatric Pulmonology Pub Date : 2025-09-01 DOI:10.1002/ppul.71312

Aurore Côté, Phoukim Savanh, Wissam Shalish, Victoria Bizgu, Anne-Marie Canakis

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Abstract

Objectives: To assess the caffeine response in preterm and term newborns with persistent intermittent hypoxia (IH) as they approach discharge, with particular focus on newborns with chronic lung disease of prematurity (CLD). To identify factors associated with a lack of response to caffeine.

Design/settings: Retrospective cohort study across two neonatal intensive care units between 2015 and 2022.

Main outcomes following caffeine administration: Normal oximetry; no need for respiratory support; resolution of hypercapnia.

Results: A total of 132 infants received caffeine for persistent IH. Normal oximetry was achieved post-caffeine in 81% (46/57) of newborns with CLD, in 96% (46/48) of preterm with no CLD, in 96% (26/27) of term newborns. Caffeine reduced the % time with SpO₂ < 90% from 6.8% (interquartile range, 3.8%-12.2%), to 0.8% (0.4%-1.6%, p < 0.0001). The desaturation index < 80% dropped from 5.3 events/hour (0.9-14.6 events/hour) to 0.2 events/hour (0-0.78 events/hour, p < 0.0001) and the desaturation index ≥ 10% lasting > 10 s went from 6.6 events/hour (3.3-10.7 events/hour) to 1.4 events/hour (0.7-2.4 events/hour, p < 0.0001). Of the 61 infants on respiratory support, 74% (45/61) were weaned within a few days following caffeine. Caffeine normalized PCO₂ in 63% (41/65) of newborns with elevated PCO₂ pre-caffeine. Infants failing caffeine were more likely to have CLD compared to responders (79% vs. 39%, p < 0.005). Caffeine was successfully discontinued (first attempt, normal oximetry) in 101 infants (88%) at postmenstrual age of 46.1 weeks (45.3-48.3 weeks).

Conclusion: Caffeine improved respiratory outcomes in the majority of preterm and term born infants with persistent IH, including those with CLD.

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咖啡因对有或无慢性肺病新生儿持续间歇性缺氧的治疗作用

目的：评估早产和足月新生儿在即将出院时持续性间歇性缺氧（IH）的咖啡因反应，特别关注患有慢性早产儿肺部疾病（CLD）的新生儿。找出对咖啡因缺乏反应的相关因素。设计/环境：2015 - 2022年间两个新生儿重症监护病房的回顾性队列研究。给药后的主要结果：血氧测定正常；不需要呼吸支持；解决高碳酸血症。结果：共有132名婴儿接受了持续性IH的咖啡因治疗。咖啡因摄入后，81%（46/57）的CLD新生儿血氧测量正常，96%（46/48）的早产儿无CLD， 96%（26/27）的足月新生儿血氧测量正常。咖啡因减少了SpO2 10 s的%时间，从6.6事件/小时（3.3-10.7事件/小时）降至1.4事件/小时（0.7-2.4事件/小时，p < 0.0001）。在61名接受呼吸支持的婴儿中，74%（45/61）在摄入咖啡因后的几天内断奶。咖啡因使63% (41/65)PCO2升高的新生儿的PCO2正常化。与应答者相比，未摄入咖啡因的婴儿更有可能发生CLD （79% vs. 39%）。结论：咖啡因改善了大多数患有持续性IH的早产儿和足月婴儿的呼吸结局，包括那些患有CLD的婴儿。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Pulmonology 医学-呼吸系统

CiteScore

6.00

自引率

12.90%

发文量

468

审稿时长

3-8 weeks

期刊介绍： Pediatric Pulmonology (PPUL) is the foremost global journal studying the respiratory system in disease and in health as it develops from intrauterine life though adolescence to adulthood. Combining explicit and informative analysis of clinical as well as basic scientific research, PPUL provides a look at the many facets of respiratory system disorders in infants and children, ranging from pathological anatomy, developmental issues, and pathophysiology to infectious disease, asthma, cystic fibrosis, and airborne toxins. Focused attention is given to the reporting of diagnostic and therapeutic methods for neonates, preschool children, and adolescents, the enduring effects of childhood respiratory diseases, and newly described infectious diseases. PPUL concentrates on subject matters of crucial interest to specialists preparing for the Pediatric Subspecialty Examinations in the United States and other countries. With its attentive coverage and extensive clinical data, this journal is a principle source for pediatricians in practice and in training and a must have for all pediatric pulmonologists.