Tropical Journal of Pharmaceutical Research

Original Research Article | OPEN ACCESS

Efficacy of caffeine citrate combined with mechanical ventilation in the treatment of apnea of prematurity and its influence on neurodevelopmental outcomes

Yingxian Liu¹, Yanpi Xie¹, Chuming You¹, Qiong Meng¹, Dongjun Liu², Zhenyu Liang¹

¹Department of Neonatal, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong Province 510000, China; ²Department of Neonatal, Shaoguan Maternal and Child Health Hospital, Shaoguan City, Guangdong Province 512029, China.

For correspondence:- Zhenyu Liang Email: liangzhenyu05@163.com Tel:+8615914305676

Accepted: 27 July 2023 Published: 31 August 2023

Citation: Liu Y, Xie Y, You C, Meng Q, Liu D, Liang Z. Efficacy of caffeine citrate combined with mechanical ventilation in the treatment of apnea of prematurity and its influence on neurodevelopmental outcomes. Trop J Pharm Res 2023; 22(8):1683-1689 doi: 10.4314/tjpr.v22i8.20

© 2023 The authors.
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Abstract

Purpose: To investigate the efficacy of caffeine citrate when combined with mechanical ventilation in the treatment of apnea of prematurity and its influence on neurodevelopmental outcomes.

Methods: One hundred and sixty (160) premature infants with apnea admitted in Guangdong Second Provincial General Hospital, Guangzhou, China were enrolled in this study, and divided into control and study groups. Children in the control group underwent mechanical ventilation combined with aminophylline therapy, while children in the study group were administered mechanical ventilation combined with caffeine citrate. Blood gas and pulmonary function indices, as well as clinical symptom and neurodevelopmental improvements were assessed. Also, the incidence of adverse reactions were recorded during treatment.

Results: Blood gas indices including oxygen partial pressure (PaO₂) and pulse oxygen saturation (SPO₂) levels in the study group were significantly higher, but partial pressure of carbon dioxide (PaCO₂) level was lower (p < 0.05); furthermore, tidal volume, respiratory rate and peak expiratory flow (PEF) in the study group were higher than in the control group (p < 0.05). On the other hand, the disappearance time of apnea, invasive mechanical ventilation time and oxygen inhalation time in the study group were shorter than in the control group (p < 0.05). Mental development index (MDI) and psychomotor development index (PDI) values in the study group were significantly higher than in the control group (p < 0.05), while the incidence of bronchopulmonary dysplasia, feeding intolerance, tachycardia and hyperglycemia in the study group was significantly lower than in the control group (p < 0.05).

Conclusion: The combination of caffeine citrate and mechanical ventilation aids improvement in the neurodevelopmental outcome of children, as well as reduction in the incidence of adverse reactions. However, further clinical trials are required prior to application of this strategy in clinical practice.

Keywords: Preterm infants, Apnea, Caffeine citrate, Mechanical ventilation therapy, Neurodevelopmental outcome