How to administer caffeine citrate in neonates?
The recommended dose regimen in previously untreated infants is a loading dose of 20 mg caffeine citrate per kg body weight administered by slow intravenous infusion over 30 minutes, using a syringe infusion pump or other metered infusion device. The group discussed the well-established advantages of caffeine over aminophylline, particularly its superior safety profile and wider therapeutic window. The discussion highlighted the key role of caffeine in improving respiratory outcomes in preterm infants and in reducing the incidence and severity of AOP.Caffeine is the most frequently used medication in the neonatal intensive care unit. It is used for the prevention and treatment of apnea, although this has been associated with lower incidence of bronchopulmonary dysplasia (BPD) and patent ductus arteriosus as well as intact survival at 18–21 months of life.While adults metabolize caffeine in about four hours, the half-life in newborns can be as long as 100 hours. Caffeine remains in an infant’s system for weeks, not hours.The infants received caffeine in doses that ranged from 36 to 136 mg/kg. On arrival in a regional newborn center, they exhibited one or more of the following symptoms: tachypnea, fine tremor of the extremities, opisthotonus, tonic-clonic movements, and nonpurposeful jaw and lip movements.Some reports have described caffeine toxicity-related tachycardia, tachypnea, irritability, jitteriness, and vomiting in preterm neonates.
When is caffeine given to newborns?
A 2014 study by Lodha showed starting caffeine therapy within two days after birth shortened the amount of time babies needed to use ventilators and reduced the risk of bronchopulmonary dysplasia, a form of chronic lung disease. Caffeine citrate, sold under the brand name Cafcit among others, is a medication used to treat a lack of breathing in premature babies.Caffeine is the most commonly used medication for treatment of apnea of prematurity. Its effect has been well established in reducing the frequency of apnea, intermittent hypoxemia, and extubation failure in mechanically ventilated preterm infants.Caffeine is the globally consumed psychoactive substance and the drug of choice for the treatment of apnea of prematurity (AOP), but its therapeutic effects are highly variable among preterm infants.Caffeine modulates various neurotransmitter systems and cellular pathways involved in brain development. As both an adenosine receptor antagonist and a free radical scavenger, caffeine helps mitigate oxidative stress, and brain injury is reduced in vulnerable neonates.Caffeine citrate is one of the most important medicines in use in NICU. Its efficacy, tolerability, wide therapeutic index, safety and its use in apnea, mechanical ventilation as well as bronchopulmonary dysplasia has made it the “Silver bullet” in neonatology.
What are the side effects of caffeine for infants?
Your baby’s body can’t handle it quite as easily, and a smaller amount can affect their functioning. Whereas you may feel energized, your baby may react to caffeine by acting jittery, anxious, or irritable. Your baby might even experience colic-like symptoms. Caffeine is also used in a variety of cosmetic products and can be administered topically, orally, by inhalation, or by injection. The caffeine citrate injection, used for apnea of the premature newborn, was initially approved by the FDA in 1999.Fussiness, jitteriness and sleeping problems have been found in babies whose mothers consumed high levels of caffeine, more than 5 cups of coffee each day. There is no agreed upon safe level of caffeine because every baby’s tolerance is different.Caffeine overdose (36 mg/kg to 136 mg/kg) and perinatal asphyxia may precipitate or increase seizure activity in term neonates [92]. Early high-dose caffeine (80 mg/kg) is associated with an increase in seizure incidence and seizure burden in premature infants ≤30 weeks GA [93].Description. Caffeine citrate injection is used to treat short-term apnea of prematurity when premature babies (infants between 28 and 32 weeks gestational age) stop breathing. Apnea of prematurity is caused by the baby’s breathing centers not being fully developed.Caffeine is the most frequently used medication in the neonatal intensive care unit. It is used for the prevention and treatment of apnea, although this has been associated with lower incidence of bronchopulmonary dysplasia (BPD) and patent ductus arteriosus as well as intact survival at 18–21 months of life.
Why is caffeine citrate used in neonates?
Caffeine citrate injection is used to treat short-term apnea of prematurity when premature babies (infants between 28 and 32 weeks gestational age) stop breathing. Apnea of prematurity is caused by the baby’s breathing centers not being fully developed. It is a bronchial smooth muscle relaxant, a CNS stimulant, a cardiac muscle stimulant, and a diuretic. Although the mechanism of action of caffeine in apnea of prematurity is not known, several mechanisms have been hypothesized.Description. Caffeine citrate injection is used to treat short-term apnea of prematurity when premature babies (infants between 28 and 32 weeks gestational age) stop breathing. Apnea of prematurity is caused by the baby’s breathing centers not being fully developed.Caffeine is a medicine that stimulates the breathing centre in the brain and helps to prevent apnoea. Caffeine is usually given once or twice a day, either intravenously into a drip, or by the feeding tube that is used to give milk to your baby.