Cochrane · systematic review · CD013873
Caffeine dosing regimens in preterm infants with or at risk for apnea of prematurity
Bruschettini, M, Brattström, P, Russo, C, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
NeonatalAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
32
current version
GRADE rated
14
No studies
17
Included studies
NR
No studies 17 · 53.1%Ungraded 1 · 3.1%Very low 10 · 31.3%Low 3 · 9.4%Moderate 1 · 3.1%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
High‐dose compared to standard‐dose strategies for any indication for preterm infants with or at risk for apnea of prematurity
Population: preterm infants with or at risk for apnea of prematurity
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality prior to hospital discharge High‐dose vs standard‐dose strategies | RR 0.86 [0.53, 1.38] | 5 studies · 723 participants | Low Downgraded: risk of bias, imprecision |
Major neurodevelopmental disability in children aged 18 to 24 months CA High‐dose vs standard‐dose strategies | no estimate extracted | NR | No studies |
Major neurodevelopmental disability in children aged 3 to 5 years CA High‐dose vs standard‐dose strategies | RR 0.79 | 1 study · 46 participants | Very low Downgraded: risk of bias, imprecision |
Mortality or major neurodevelopmental disability in children aged 18 to 24 months and 3 to 5 years CA High‐dose vs standard‐dose strategies | no estimate extracted | NR | No studies |
Bronchopulmonary dysplasia/chronic lung disease (BPD) at 36 weeks' postmenstrual age High‐dose vs standard‐dose strategies | RR 0.75 [0.6, 0.94] | 5 studies · 723 participants | Moderate Downgraded: risk of bias |
Side effects (tachycardia, agitation, or feed intolerance) leading to a reduction in dose or withholding of caffeine High‐dose vs standard‐dose strategies | RR 1.66 [0.86, 3.23] | 5 studies · 593 participants | Low Downgraded: risk of bias, imprecision |
Duration of hospital stay(days) High‐dose vs standard‐dose strategies | no estimate extracted | 3 studies · 3 participants | Ungraded |
Seizures (clinically diagnosed; diagnosed by electroencephalography) High‐dose vs standard‐dose strategies | RR 1.42 [0.79, 2.53] | 1 study · 74 participants | Very low Downgraded: risk of bias, imprecision |
High‐dose compared to standard‐dose strategies for prevention of apnea for preterm infants with or at risk for apnea of prematurity
Population: preterm infants at risk for apnea of prematurity
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality prior to hospital discharge High‐dose vs standard‐dose strategies | RR 1.32 [0.5, 3.53] | 2 studies · 152 participants | Very low Downgraded: risk of bias, imprecision |
Major neurodevelopmental disability in children aged 18 to 24 months CA High‐dose vs standard‐dose strategies | no estimate extracted | NR | No studies |
Major neurodevelopmental disability in children aged 3 to 5 years CA High‐dose vs standard‐dose strategies | RR 0.79 [0.51, 1.24] | 1 study · 46 participants | Very low Downgraded: risk of bias, imprecision |
Mortality or major neurodevelopmental disability in children aged 18 to 24 months and 3 to 5 years CA High‐dose vs standard‐dose strategies | no estimate extracted | NR | No studies |
Bronchopulmonary dysplasia/chronic lung disease (BPD) at 36 weeks' postmenstrual age High‐dose vs standard‐dose strategies | RR 0.89 [0.61, 1.3] | 2 studies · 152 participants | Very low Downgraded: risk of bias, imprecision |
Side effects (tachycardia, agitation, or feed intolerance) leading to a reduction in dose or withholding of caffeine High‐dose vs standard‐dose strategies | no estimate extracted | NR | No studies |
Duration of hospital stay (days) High‐dose vs standard‐dose strategies | no estimate extracted | 1 study · 1 participants | Very low Downgraded: risk of bias, imprecision |
Seizures (clinically diagnosed; diagnosed by electroencephalography) High‐dose vs standard‐dose strategies | no estimate extracted | NR | No studies |
High‐dose compared to standard‐dose strategies for treatment of apnea for preterm infants with or at risk for apnea of prematurity
Population: preterm infants with or at risk for apnea of prematurity
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality prior to hospital discharge High‐dose vs standard‐dose strategies | RR 0.75 [0.4, 1.4] | 3 studies · 333 participants | Very low Downgraded: risk of bias, imprecision |
Major neurodevelopmental disability in children aged 18 to 24 months CA High‐dose vs standard‐dose strategies | no estimate extracted | NR | No studies |
Major neurodevelopmental disability in children aged 3 to 5 years CA High‐dose vs standard‐dose strategies | no estimate extracted | NR | No studies |
Mortality or major neurodevelopmental disability in children aged 18 to 24 months and 3 to 5 years CA High‐dose vs standard‐dose strategies | no estimate extracted | NR | No studies |
Bronchopulmonary dysplasia/chronic lung disease (BPD) at 36 weeks' postmenstrual age High‐dose vs standard‐dose strategies | RR 0.72 [0.47, 1.11] | 3 studies · 333 participants | Very low Downgraded: risk of bias, imprecision |
Side effects (tachycardia, agitation or feed intolerance) leading to a reduction in dose or withholding of caffeine: high‐loading and high‐maintenance dose standard‐loading and standard‐maintenance dose High‐dose vs standard‐dose strategies | RR 1.92 [0.53, 6.9] | 2 studies · 150 participants | Very low Downgraded: risk of bias, imprecision |
Duration of hospital stay (days) High‐dose vs standard‐dose strategies | no estimate extracted | NR | No studies |
Seizures (clinically diagnosed; diagnosed by electroencephalography) High‐dose vs standard‐dose strategies | no estimate extracted | NR | No studies |
High‐dose compared to standard‐dose strategies for the prevention of re‐intubation for preterm infants with or at risk for apnea of prematurity
Population: preterm infants with or at risk for apnea of prematurity
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality prior to hospital discharge High‐dose vs standard‐dose strategies | RR 0.75 [0.25, 2.3] | 1 study · 238 participants | Very low Downgraded: risk of bias, imprecision |
Major neurodevelopmental disability in children aged 18 to 24 months CA High‐dose vs standard‐dose strategies | no estimate extracted | NR | No studies |
Major neurodevelopmental disability in children aged 3 to 5 years CA High‐dose vs standard‐dose strategies | no estimate extracted | NR | No studies |
Mortality or major neurodevelopmental disability in children aged 18 to 24 months and 3 to 5 years CA High‐dose vs standard‐dose strategies | no estimate extracted | NR | No studies |
Bronchopulmonary dysplasia/chronic lung disease (BPD) at 36 weeks' postmenstrual age High‐dose vs standard‐dose strategies | RR 0.68 [0.48, 0.97] | 1 study · 238 participants | Low Downgraded: risk of bias, imprecision |
Side effects (tachycardia, agitation, or feed intolerance) leading to a reduction in dose or withholding of caffeine High‐dose vs standard‐dose strategies | no estimate extracted | NR | No studies |
Duration of hospital stay (days) High‐dose vs standard‐dose strategies | no estimate extracted | NR | No studies |
Seizures (clinically diagnosed; diagnosed by electroencephalography) High‐dose vs standard‐dose strategies | no estimate extracted | NR | No studies |