Caffeine use in preterm neonates: national insights into Turkish NICU practices

Caffeine use in preterm neonates: national insights into Turkish NICU practices

ObjectiveCaffeine is a proven medication used for the prevention and treatment of apnea in premature infants, offering both short- and long-term benefits. International guidelines provide a range of recommendations regarding the preterm population eligible for caffeine prophylaxis, including the tim...

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Main Authors: Sezin Unal, Serdar Beken, Deniz Anuk Ince, Ozden Turan, Ayse Korkmaz Toygar, Ayse Ecevit, Abdullah Baris Akcan, Mustafa Ali Akın, Selma Aktas, Nukhet Aladag Ciftdemir, Emel Altuncu, Huseyin Altunhan, Baran Cengiz Arcagok, Didem Armangil, Esra Arun Ozer, Banu Aydın, Handan Bezirganoglu, Leyla Bilgin, Erhan Calısıcı, Sebnem Calkavur, Kıymet Celik, Yalcın Celik, Bilin Cetinkaya, Merih Cetinkaya, Atalay Demirel, Gamze Demirel, Nazan Neslihan Dogan, Pelin Doğan, Mehtap Durukan, Defne Engur, Tugba Erener Ercan, Zeynel Gokmen, Ipek Guney Varal, Selvi Gulası, Ayla Gunlemez, Tugba Gursoy, Handan Hakyemez Toptan, Serif Hamitoğlu, Fatih Isleyen, Irem Iyigun, Sebnem Kader, Dilek Kahvecioğlu, Gozdem Kaykı, Murat Kostu, Dilek Kurnaz, Tural Mammadalıyev, Ilke Mungan Akin, Nejat Narlı, Emel Okulu, Nilufer Okur, Ozgur Olukman, Fahri Ovalı, Beyza Ozcan, Ahmet Ozdemir, Ozmert Ozdemir, Hilal Ozkan, Gonca Sandal, Dilek Sarıcı, Cansu Sivrikaya, Betul Siyah Bilgin, Saime Sundus, Ozge Surmeli Onay, Huseyin Simsek, Umit Ayse Tandırcıoğlu, Sema Tanrıverdi, Kadir Serafettin Tekgunduz, Demet Terek, Gaffari Tunc, Turan Tunc, Ercan Tutak, Eda Tufekcioğlu, Funda Tuzun Erdogan, Ersin Ulu, Dilek Ulubas Isik, Nurdan Uras, Sait Ilker Uslu, Irem Unal, Fatma Hilal Yılmaz, Ariorad Moniri
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-02-01
Series:Frontiers in Pediatrics
Subjects:
caffeine
premature neonate
apnea of prematurity
neonatal intensive care unit
guideline
Online Access:https://www.frontiersin.org/articles/10.3389/fped.2025.1492716/full
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Summary:ObjectiveCaffeine is a proven medication used for the prevention and treatment of apnea in premature infants, offering both short- and long-term benefits. International guidelines provide a range of recommendations regarding the preterm population eligible for caffeine prophylaxis, including the timing, dosage, and duration of treatment. Our national guidelines, published prior to the most recent updates of the international guidelines, recommend the use of caffeine citrate starting from the first day after delivery for preterm infants with a gestational age of <28 weeks. For infants up to 32 weeks, if positive pressure ventilation is required, the decision should be made on an individual basis. This study aims to describe the variability in caffeine usage across neonatal intensive care units in our country.MethodsAn online survey was sent to neonatologist who are members of the Turkish Neonatology Society to describe the variability in caffeine usage in neonatal intensive care units in our country.ResultsWe collected responses from 74 units. Prophylactic caffeine usage was observed as; GA ≤276/7: 98.6%, GA 280/7–286/7: 89.0%, GA 290/7–296/7: 75.3%, GA 300/7–316/7: 53.4%. 62.2% of units reported administering loading dose within the first two hours. The initial maintenance dose was 5 mg/kg in 64.8% of units, 10 mg/kg in 32.4% of units, and intermediate dose in 5.3% of units. 47.3% of units reported no routine dose adjustment. The postmenstrual age that caffeine treatment was stopped was found to be 34 (min-max; 32–36) weeks for infants without apnea and respiratory support, 36 (min-max; 34–52) weeks for infants without apnea but any respiratory support. The time to discharge after treatment cessation was found as; 1–4 days: 37.8%, 5–7 days: 68.9%. Among the 56 units with multiple responsible physicians, 32.1% reported intra-unit variations.ConclusionThe significant differences in caffeine usage characteristics between and within units highlight the need for clear recommendations provided by standardized guidelines.
ISSN:2296-2360

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