CLINICAL SIGNIFICANCE OF CAFFEINE THERAPY IN REDUCING APNEA EPISODES IN PRETERM INFANTS

Apnea of prematurity is a common condition in preterm infants, manifesting as episodes of breathing cessation with bradycardia and hypoxemia due to immature respiratory control. This syndrome increases neonatal morbidity and mortality risk. Methylxanthines, especially caffeine citrate, are considered the most effective therapy to prevent and treat apnea.Objective: To evaluate the clinical efficacy of caffeine citrate therapy in preterm infants with apnea.In this clinical study, 80 preterm infants with apnea received comprehensive treatment including caffeine citrate (loading dose 20 mg/kg IV, followed by 5 mg/kg per day orally). By day 5 of therapy, respiratory status and laboratory and instrumental parameters were assessed.Within 3–5 days from treatment initiation, 70% of infants had complete cessation of apnea episodes, and the remaining 30% showed a significant reduction in frequency (<3 episodes/day). Spontaneous breathing was restored in 85% of infants; CPAP support was weaned by day 3–5 in 62.5% of cases, and need for mechanical ventilation decreased in 37.5%. Blood gas and metabolic indices improved: arterial pH increased with reduction in pCO₂, lactate level decreased, and electrolyte balance normalized (Table 1). In addition, signs of inflammation subsided as serum interleukin-1, TNF-α, and C-reactive protein levels significantly declined post-treatment (Table 2). Lung ultrasound indicated a two-fold reduction in interstitial syndrome signs, and cranial ultrasound showed ~60% decrease in frequency and severity of intraventricular hemorrhages.