• N R Dobson, L M Rhein, R A Darnall, M J Corwin, T C Heeren, E Eichenwald, L P James, B L McEntire, C E Hunt, and Caffeine Study Group.
• Department of Pediatrics, Uniformed Services University of Health Sciences, Bethesda, MD, USA.
• J Perinatol. 2017 Oct 1; 37 (10): 1135-1140.

ObjectiveTo determine whether intermittent hypoxia (IH) persisting after 36 weeks postmenstrual age (PMA) can be attenuated using caffeine doses sufficient to maintain caffeine concentrations >20 μg ml-1.Study DesignTwenty-seven infants born <32 weeks were started on caffeine citrate at 10 mg kg-1 day-1 when clinical caffeine was discontinued. At 36 weeks PMA, the dose was increased to 14 or 20 mg kg-1 day-1 divided twice a day (BID) to compensate for progressively increasing caffeine metabolism. Caffeine concentrations were measured weekly. The extent of IH derived from continuous pulse oximetry was compared to data from 53 control infants.ResultThe mean (s.d.) gestational age of enrolled infants was 27.9±2 weeks. Median caffeine levels were >20 μg ml-1 on study caffeine doses. IH was significantly attenuated through 38 weeks PMA compared with the control group.ConclusionCaffeine doses of 14 to 20 mg kg-1 day-1 were sufficient to maintain caffeine concentrations >20 μg ml-1 and reduce IH in preterm infants at 36 to 38 weeks PMA.

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