The use of caffeine in premature infants with apnea: dosage and preventive application

Caffeine is used worldwide and has become the first-line treatment for apnea in pediatric intensive care units. Compared with other methylxanthines, caffeine has better therapeutic efficacy and fewer adverse reactions. Various studies have determined the clinical relevance and usefulness of caffeine. With the gradual development of precision medicine and the goal of improving the long-term prognosis of children, the optimal dose of caffeine has become a primary focus of clinical research. Recent clinical trials have shown that high-dose caffeine citrate has a better effect on apnea, can effectively increase the extubation rate, reduce the incidence of adverse reactions, prevent bronchopulmonary dysplasia, and reduce the occurrence of cerebral palsy and cognitive impairment. However, the preventive use of caffeine in preterm infants and the optimal maintenance dose remain controversial. Therefore, large-scale randomized controlled trials are needed to determine and establish standard protocols for using caffeine treatment, specifically in younger populations.