title: Early caffeine therapy and clinical outcomes in extremely preterm infants.
abstract: OBJECTIVE
  To determine if early caffeine (EC) therapy is associated with decreased bronchopulmonary dysplasia (BPD) or death, decreased treatment of patent ductus arteriosus (PDA), or shortened duration of ventilation.
  
  
  METHODS
  In a retrospective cohort of 140 neonates ≤1250 g at birth, infants receiving EC (initiation <3 days of life) were compared with those receiving late caffeine (LC, initiation ≥3 days of life) using logistic regression.
  
  
  RESULTS
  Of infants receiving EC, 25% (21/83) died or developed BPD compared with 53% (30/57) of infants receiving LC (adjusted odds ratio (aOR) 0.26, 95% confidence interval (CI) 0.09 to 0.70; P<0.01). PDA required treatment in 10% of EC infants versus 36% of LC infants (aOR 0.28, 95%CI 0.10 to 0.73; P=0.01). Duration of mechanical ventilation was shorter in infants receiving EC (EC, 6 days; LC, 22 days; P<0.01).
  
  
  CONCLUSIONS
  Infants receiving EC therapy had improved neonatal outcomes. Further studies are needed to determine if caffeine prophylaxis should be recommended for preterm infants.
authors.affiliation: Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA. rmpatel@emory.edu
authors.forename: R M
authors.initials: RM
authors.lastname: Patel
authors.forename: T
authors.initials: T
authors.lastname: Leong
authors.forename: D P
authors.initials: DP
authors.lastname: Carlton
authors.forename: S
authors.initials: S
authors.lastname: Vyas-Read
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000175:diagnosis / Q000188:drug therapy*; D002110:Caffeine / Q000627:therapeutic use*; D015331:Cohort Studies; D016001:Confidence Intervals; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004374:Ductus Arteriosus, Patent / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D062606:Tertiary Care Centers; D016896:Treatment Outcome
chemical_list: D002110:Caffeine