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Careful caffeine dosing in NICUs is critical to avoid growth delays and lengthy hospitalization in preterm babies while assuring effective treatment for apnea of prematurity.
While a standard caffeine dose (5 mg/kg/day) supports better growth of early-born infants, higher doses (>7 mg/kg/day) result in notably lower weight gain and more complications, including fast heart rate (tachycardia) and feeding intolerance, a study issued in BMC Pediatrics journal revealed.
Caffeine citrate is a common treatment in neonatal intensive care units (NICUs) due to its neuroprotective and respiratory benefits. However, when given in excessive amounts, it can increase energy expenditure and cause diuresis and natriuresis, which may hinder growth. This retrospective cohort study by Saeed Ahmed et al. analyzed 314 preterm neonates, comparing those on standard caffeine doses with those receiving higher doses during two postnatal periods (days 15-28 and days 29-42 of life).|
To fulfil the basis of the study, participants were divided into three groups based on their daily caffeine dosage: Group I (standard dose of 5 mg/kg daily), Group II (>5-7 mg/kg daily), and Group III (>7 mg/kg daily) monitored over two postnatal phases. Regular weight gain, side effects of caffeine, and other risk factors like caloric consumption, duration of parenteral nutrition, and exposure to steroids, diuretics and Ibuprofen were assessed.
From days 15 to 28, the findings showed that infants on standard doses gained weight drastically better than those on higher doses. By days 29 to 42, the difference remained noteworthy between the standard and the highest dose group. Additionally, higher doses were related to more frequent side effects (fast heart rate and inability to digest enteral feedings), which were linked to decreased weight gain.
BMC Pediatrics
Predictors for poor daily weight gain in preterm neonates exposed to different dose regimens of Caffeine in ICU- a retrospective cohort study
Saeed Ahmed et al.
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