Clinical effects of caffeine during weaning of mechanical ventilation in very/extreme low birth weight premature infants / 中国新生儿科杂志

ABSTRACT

Objective To study the clinical effects of caffeine during weaning of mechanical ventilation in very/extreme low birth weight ( VLBW/ELBW) premature infants.Method From January 2013 to December 2014, VLBW/ELBW premature infants with early mechanical ventilation in the neonatal department of our hospital were enrolled in the retrospective study.The infants were assigned into control group (admitted in 2013 ) and observation group ( admitted in 2014).Infants in the observation group received caffeine citrate 24 hours before extubation, and the control group didn′t.Both groups were treated with nasal continuous positive airway pressure ( NCPAP) after extubation.The success rate of weaning , duration of hospital stay, duration of non－invasive assisted ventilation,duration of oxygen application and the incidences of related complications were compared between the two groups .Result A total of 100 cases were studied, including 50 cases in the control group and 50 in the observation group, respectively.No significant differences were found between the two groups in gender , gestational age, birth weight, neonatal respiratory distress syndrome severity , mechanical ventilation duration , prenatal glucocorticoid use and the proportion of high risk factors of intrauterine infection ( P ＞0.05 ).The success rate of weaning in the observation group was higher than the control group ( 96.0% vs.82.0%).Duration of hospital stay (49.7 ±2.3 days), non－invasive ventilation duration ( 9.1 ±0.9 days ), and oxygen use ( 23.1 ± 1.9 days) in the observation group were all shorter than the control group ( 56.4 ±2.1 days, 12.2 ± 1.2 days, 32.8 ±2.5 days, respectively).The incidence of bronchopulmonary dysplasia (BPD) was significantly lower than the control group (40.0% vs.62.0%, P＜0.05).No significant differences were found in the incidences of feeding intolerance and necrotizing enterocolitis (NEC) between the two groups (P＞0.05).Conclusion The use of caffeine 24 hours before weaning in combination with NCPAP can improve the success rate of weaning , reduce the incidence of BPD without increasing the incidence of feeding intolerance and NEC in VLBW/ELBW infants with mechanical ventilation.