title: Apnea of prematurity and caffeine pharmacokinetics: potential impact on hospital discharge.
abstract: OBJECTIVE
  To determine the half-life of serum caffeine concentrations and its relation to apnea of prematurity (AOP) after caffeine is discontinued in preparation for hospital discharge.
  
  
  METHODS
  Prospective cohort study involving preterm infants with gestational ages ⩽33 weeks at birth. After caffeine was discontinued, serum caffeine concentrations and electronic detection of pathologic apnea, defined a priori, were obtained at 24 and 168 h, respectively.
  
  
  RESULTS
  Caffeine levels decreased from 13.3±3.8 to 4.3±2 mg l(-1) (n=50, mean±s.d.) at 24 and 168 h, respectively (P<0.01). The mean caffeine half-life was 87±25 h at 35±1 weeks postmenstrual age. Seven days after discontinuation of caffeine, 64% of the infants had pathologic apnea.
  
  
  CONCLUSIONS
  Hospital discharge planning for preterm infants with a history of AOP should be carefully considered after discontinuing caffeine. This study showed that caffeine may not reach subtherapeutic levels until around 11-12 days.
authors.affiliation: Department of Pediatrics, Stony Brook Children's Hospital, Stony Brook, NY, USA.
authors.forename: J
authors.initials: J
authors.lastname: Doyle
authors.affiliation: Department of Pediatrics, Stony Brook Children's Hospital, Stony Brook, NY, USA.
authors.forename: D
authors.initials: D
authors.lastname: Davidson
authors.affiliation: Department of Pediatrics, Stony Brook Children's Hospital, Stony Brook, NY, USA.
authors.forename: S
authors.initials: S
authors.lastname: Katz
authors.affiliation: Department of Pharmacy, Stony Brook Children's Hospital, Stony Brook, NY, USA.
authors.forename: M
authors.initials: M
authors.lastname: Varela
authors.affiliation: Department of Pediatrics, Stony Brook Children's Hospital, Stony Brook, NY, USA.
authors.forename: D
authors.initials: D
authors.lastname: Demeglio
authors.affiliation: Department of Pediatrics, Stony Brook Children's Hospital, Stony Brook, NY, USA.
authors.forename: J
authors.initials: J
authors.lastname: DeCristofaro
mesh_terms: D001049:Apnea / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D002110:Caffeine / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics; D016903:Drug Monitoring / Q000379:methods; D005260:Female; D005865:Gestational Age; D006207:Half-Life; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000628:therapy*; D007234:Infant, Premature; D008297:Male; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge / Q000592:standards; D058915:Purinergic P1 Receptor Antagonists / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics; D013997:Time Factors; D028761:Withholding Treatment / Q000592:standards
chemical_list: D058915:Purinergic P1 Receptor Antagonists; D002110:Caffeine