Clinical Research Of Caffeine Citrate For Prevent Apnea And Mechanical Ventilation Support In Preterm Infants

ObjectivesTo investigate the clinical efficacy of caffeine citrate for prevent primary apnea and the application for mechanical ventilation support in preterm infants.MethodA non-randomized controlled trial had been designed in which 64 preterm infants(gestational age less than 34week)would be enrolled from Jan 2014 to Sep 2015 in our hospital.According to the economic factors,the babies were divided into treatment group(n=30)and control group(n=34).The treatment group was treated with caffeine citrate,and control group was blank.The overall response rates in the two groups were compared.Preterm infants(gestational age less than 34week)that need CPAP in our NICU from Jan2014 to Sep 2015.They were randomly assigned to caffeine citrate group(n=51)and blank control group(n=45).The non-invasive mechanical ventilation duration and the incidence of reuse CPAP,BPD severe ROP,PIVH,weight gain,feeding intolerance were compared between the two groups.Very low birth weight(AGA)that need mechanical ventilation in our NICU from Jan 2014 to Sep 2015.They were randomly assigned to caffeine citrate group(n=43)and blank control group(n=41).The mechanical ventilation duration and the incidence of re-intubation,BPD,severe ROP,PIVH,weight gain,feeding intolerance were compared between the two groups.Result1.For the preterm infants,comparing with blank control group,the incidence of apnea was less in caffeine citrate group(4/30vs12/34,P<0.05).2.For the preterm infant(the treatment group was treated caffeine citrate when use CPAP),the effective rate of the treatment group was 100%,while the blank control group was 88.89%(51/51vs40/45,x~2=5.978,P<0.05).For the treatment group,non-invasive mech-anical ventilation duration was shorter than control group(P<0.01)and oxygen time after CPAP was shorter than control group(P<0.05).3.For the VLBW(the treatment group was use caffeine citrate when ventilation in SIMV mode),the effective rate of the treatment group was 97.67%,while the control group was 85.37%(42/43vs35/41,x~2=4.163,P<0.05);mechanical ventilation duration was shorter than control group(P<0.005).4.For the preterm infant who need CPAP or VLBW who need mechanical ventilatio-n,the incidence of BPD(4/94vs11/86),showed significant difference between the two grou-ps(P<0.005).No statistically significant difference existed between the two groups in sev-ere ROP,PIVH,weight gain,feeding intolerance(P>0.05).ConclusionCaffeine citrate is significantly effective for prevent primary apnea in preterm infant-s.Combined utilization caffeine citrate for the preterm infant who need CPAP and VLBW when ventilation in SIMV mode can reduce the incidence of reuse CPAP and re-intubation,shorten mechanical ventilation duration and reduces the BPD.