title: Caffeine for the Treatment of Apnea in Bronchiolitis: A Randomized Trial.
abstract: To evaluate the efficacy and safety of caffeine citrate in the treatment of apnea in bronchiolitis.
  
  
  
  Eligible infants aged ≤4 months presenting to the main pediatric emergency service with apnea associated bronchiolitis were stratified by gestational age (<34 weeks or longer) and randomized to receive a single dose of intravenous 25 mg/kg caffeine citrate or saline placebo. The primary efficacy outcome was a 24-hour apnea-free period beginning after completion of the blinded study drug infusion. Secondary outcomes were frequency of apnea by 24, 48, and 72 hours after study medication, need for noninvasive/invasive ventilation, and length of stay in the hospital's pediatric intensive care/step-down unit.
  
  
  
  A total of 90 infants diagnosed with viral bronchiolitis associated with apnea (median age, 38 days) were enrolled. The rate of respiratory virus panel positivity was similar in the 2 groups (78% for the placebo group vs 84% for the caffeine group). The geometric mean duration to a 24-hour apnea-free period was 28.1 hours (95% CI, 25.6-32.3 hours) for the caffeine group and 29.1 hours (95% CI, 25.7-32.9 hours) for the placebo group (P = .88; OR, 0.99; 95% CI, 0.83-1.17). The frequency of apnea at 24 hours, 24-48 hours, and 48-72 hours after enrollment and the need for noninvasive and invasive ventilation were similar in the 2 groups. No safety issues were reported.
  
  
  
  A single dose of caffeine citrate did not significantly reduce apnea episodes associated with bronchiolitis.
  
  
  
  Clinicaltrials.gov: NCT01435486.
authors.affiliation: Division of Pediatric Emergency Medicine, Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar; Division of Pediatric Emergency Medicine, Department of Pediatrics, Sidra Medical and Research Center, Doha, Qatar; Weill Cornell Medical College in Qatar, Doha, Qatar. Electronic address: dkmaa@hotmail.com.
authors.forename: Khalid
authors.initials: K
authors.lastname: Alansari
authors.affiliation: Division of Pediatric Emergency Medicine, Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Fatihi Hassan
authors.initials: FH
authors.lastname: Toaimah
authors.affiliation: Division of Pediatric Emergency Medicine, Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Hany
authors.initials: H
authors.lastname: Khalafalla
authors.affiliation: Division of Pediatric Emergency Medicine, Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Lamiaa Awny
authors.initials: LA
authors.lastname: El Tatawy
authors.affiliation: Pulmonary-Critical Care Medicine Division, University of Washington School of Medicine, Seattle, WA.
authors.forename: Bruce L
authors.initials: BL
authors.lastname: Davidson
authors.affiliation: Division of Pediatric Emergency Medicine, Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Wessam
authors.initials: W
authors.lastname: Ahmed
mesh_terms: D001049:Apnea / Q000188:drug therapy* / Q000209:etiology*; D001988:Bronchiolitis / Q000150:complications*; D002110:Caffeine / Q000627:therapeutic use*; D002951:Citrates / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male
chemical_list: D002951:Citrates; D002110:Caffeine; C026189:caffeine citrate
keywords: apnea; bronchiolitis; caffeine citrate; respiratory syncytial virus