Clinical effect and safety of different maintenance doses of caffeine citrate in treatment of apnea in very low birth weight preterm infants: a prospective randomized controlled trial / 中国当代儿科杂志

OBJECTIVE@#To study the clinical effect and safety of different maintenance doses of caffeine citrate in the treatment of apnea in very low birth weight preterm infants.@*METHODS@#A total of 78 very low birth weight preterm infants with primary apnea were enrolled who were admitted from January 2016 to January 2018. They were randomly divided into high-dose caffeine group with 38 children and low-dose caffeine group with 40 children. Both groups received a loading dose of 20 mg/kg caffeine citrate, and 24 hours later, the children in the high-dose caffeine group were given a maintenance dose of 10 mg/kg, and those in the low-dose caffeine group were given a maintenance dose of 5 mg/kg. The two groups were compared in terms of response rate and incidence rate of adverse events.@*RESULTS@#The high-dose caffeine group had a significantly higher response rate than the low-dose caffeine group (71% vs 48%; P0.05). There was no significant difference in the mortality rate between the two groups (P>0.05).@*CONCLUSIONS@#Higher maintenance dose of caffeine citrate has a better clinical effect than lower maintenance dose of caffeine citrate in the treatment of apnea in very low birth weight preterm infants, without increasing the incidence rates of adverse drug reactions and serious complications in preterm infants.

Combined use of pulmonary surfactants with continuous distending pressure is useful in the treatment of respiratory distress syndrome in very low birth weight infants / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the efficacy of pulmonary surfactants (PS) combined with continuous distending pressure (CDP) for treatment of respiratory distress syndrome (RDS) in very low birth weight (VLBW) infants.</p><p><b>METHODS</b>Ninety VLBW infants with RDS (weight <1500 g, gestational age <34 weeks) were randomly treated with a combination of PS and the Infant Flow Advance system which can provide CDP, PS alone or the Infant Flow Advance system alone (n=30 in each group). Clinical symptoms, signs, and blood gas changes were assessed 1, 6, 12 and 24 hrs after treatment. The treatment outcomes were compared between the three groups.</p><p><b>RESULTS</b>Clinical symptoms and signs, as well as the values of PaO2, PaCO2 and pH, in the three groups were improved 1, 6, 12 and 24 hrs after treatment. The combined use of PS with CDP produced a higher PaO2 and a lower PaCO2 compared with the PS or CDP use alone (P<0.01). The combination treatment group had shorter duration of oxygen therapy and shorter length of hospital stay than the PS or CDP use alone group.</p><p><b>CONCLUSIONS</b>The combined use of PS with CDP can effectively improve pulmonary oxygenation and ventilation and shorten the duration of oxygen therapy and the length of hospital stay in VLBW infants with RDS.</p>