Efficacy and Safety Evaluation of Different Maintenance Dose Regimens of Caffeine Citrate in the Treatment of Primary Apnea in Preterm Infants

We have investigated the efficacy and safety of different maintenance doses of caffeine citrate in the treatment of primary apnea in preterm infants. To this end, apneic premature infants were treated with 5 mg/kg (low dose) or 10 mg/kg (high dose) caffeine citrate, and the frequency of apnea at 48 h and 72 h, improvement of clinical symptoms, respiratory mechanics parameters related to lung function, and blood gas analysis indexes were compared between the two groups, and safety was evaluated. The frequency of apnea at 48 h and 72 h was significantly lower in the high-dose group than in the low-dose group, and the difference was statistically significant (P < 0.05). The time to resolution of apnea, the time to mechanical ventilation, and the time to citrate use were significantly shorter in the high-dose group than in the low-dose group (P < 0.05). The tidal volume and peak expiratory flow values were significantly higher in the high-dose group than in the low-dose group (P < 0.05). The oxygen partial pressure and pulse oximetry levels in the blood gas analysis indexes of the high-dose group were significantly higher than those of the low-dose group, and the partial pressure of carbon dioxide level was significantly lower than that of the low-dose group, with statistically significant differences (P < 0.05). The safety evaluation results showed no significant difference in the rate of adverse reactions and short-term complications between the high-dose group and the low-dose group (P > 0.05). Caffeine citrate at a maintenance dose of 10 mg/kg can effectively reduce the frequency of apnea, shorten the improvement time of clinical symptoms, and improve the lung function and blood gas analysis level of children with a high safety profile.