Early caffeine initiation tied to better outcomes in preterm infants with RDS
In preterm infants with respiratory distress syndrome (RDS), early initiation of caffeine therapy is associated with lower incidences of patent ductus arteriosus (PDA) and intraventricular haemorrhage (IVH), a recent study shows.
The researchers evaluated the complications of prematurity and need for ventilator support in 844 preterm infants. Early caffeine therapy, initiated within the first 24 hours of life, was reported in 80.1 percent (n=676) of the infants and was associated with reduced need for ventilation.
For instance, significantly less infants in the early caffeine initiation group needed invasive ventilation than in the late initiation group (n=19.9 percent; 168; 71.3 vs 83.2 percent; p=0.0165). Total duration of mechanical ventilation was also significantly shorter in the early than in the late initiation group (5±11.1 vs 10.8±14.6 days; p=0.000).
The incidence rate of PDA was significantly lower in the early than in the late caffeine therapy initiation group (25 vs 37 percent; p=0.0427). Early initiation was also associated with a significantly lower risk of PDA (odds ratio [OR], 0.5686; 95 percent CI, 0.3395–0.9523).
In terms of secondary endpoints, IVH was significantly more common in the late than in the early initiation group (60.1 vs 42.1 percent; p=0.0039), and early caffeine initiation was associated with a significantly reduced IVH risk (OR, 0.4827; 0.2999–0.7787).
In contrast, the timing of caffeine therapy initiation had no significant impact on the occurrence of grade 3 or 4 IVH and on mortality rates, which were statistically similar between the two groups before hospital discharge (8.6 vs 8.5 percent).