ABSTRACT
OBJECTIVES@#To explore the optimal maintenance dose of caffeine citrate for preterm infants requiring assisted ventilation and caffeine citrate treatment.@*METHODS@#A retrospective analysis was performed on the medical data of 566 preterm infants (gestational age ≤34 weeks) who were treated and required assisted ventilation and caffeine citrate treatment in the neonatal intensive care unit of 30 tertiary hospitals in Jiangsu Province of China between January 1 and December 31, 2019. The 405 preterm infants receiving high-dose (10 mg/kg per day) caffeine citrate after a loading dose of 20 mg/kg within 24 hours after birth were enrolled as the high-dose group. The 161 preterm infants receiving low-dose (5 mg/kg per day) caffeine citrate were enrolled as the low-dose group.@*RESULTS@#Compared with the low-dose group, the high-dose group had significant reductions in the need for high-concentration oxygen during assisted ventilation (P=0.044), the duration of oxygen inhalation after weaning from noninvasive ventilation (P<0.01), total oxygen inhalation time during hospitalization (P<0.01), the proportion of preterm infants requiring noninvasive ventilation again (P<0.01), the rate of use of pulmonary surfactant and budesonide (P<0.05), and the incidence rates of apnea and bronchopulmonary dysplasia (P<0.01), but the high-dose group had a significantly increased incidence rate of feeding intolerance (P=0.032). There were no significant differences between the two groups in the body weight change, the incidence rates of retinopathy of prematurity, intraventricular hemorrhage or necrotizing enterocolitis, the mortality rate, and the duration of caffeine use (P>0.05).@*CONCLUSIONS@#This pilot multicenter study shows that the high maintenance dose (10 mg/kg per day) is generally beneficial to preterm infants in China and does not increase the incidence rate of common adverse reactions. For the risk of feeding intolerance, further research is needed to eliminate the interference of confounding factors as far as possible.
Subject(s)
Humans , Infant , Infant, Newborn , Caffeine/therapeutic use , Citrates , Infant, Premature , Respiration, Artificial , Retrospective StudiesABSTRACT
Objective To investigate role of interleukin-1?(IL-1?),interleukin-8(IL-8),tumor necrosis factor-?((TNF-?)) and insulinlike growth factor-1(IGF-1) in meconium aspiration syndrome(MAS) in newborns.Methods The concentrations of(IL-1?),IL-8,TNF-? and IGF-1 in peripheral serum were detected in 32 newborns with MAS and 15 normal newborns by radio-immunity at the first,the third and seventh day after being born.Correlations between IGF-1 and changes of IL-1?,IL-8,TNF-? was analyzed.Results Compared with control group,the concentration of IL-1?,IL-8 and TNF-? increased significantly in newborns with MAS in three days after being born(all P0.05).On the other hand, the concentration of IGF-1 in newborns with MAS was obviously lower than that of normal newborns one week after birth.The concentration of IGF-1 showed negative correlations with that of IL-1?,IL-8 and TNF-?(r=-0.67,-0.61,-0.73 all P