Caffeine Helps Premature Babies' Lungs
Study's Early Results Show Less Need of Supplemental Oxygen With Caffeine Therapy
Caffeine Study continued...
The babies in the caffeine group got an initial intravenous dose of caffeine, followed by a smaller daily maintenance dose of caffeine.
Schmidt's team tweaked the daily maintenance doses as the babies gained weight, using oral doses when the babies could tolerate it. On average, the babies received 37 days on caffeine therapy.
All babies got nondrug therapies as needed to help with breathing. Nondrug therapies included supplemental oxygen, continuous positive airway pressure (CPAP), and assisted ventilation through a tube inserted in the trachea (endotracheal tube). The trachea is the part of the airway also known as the windpipe.
Caffeine and Weight Gain
The early results cover the babies until they left the hospital.
Of the babies that lived to 36 weeks after their mothers' last menstrual period, fewer of those that got caffeine therapy needed supplemental oxygen. Those babies also stopped needing CPAP, an endotracheal tube, and supplemental oxygen one week earlier than the babies in the comparison group.
The babies in the caffeine group also temporarily gained less weight than those in the comparison group, the study shows. The average weight difference between the two groups was greatest at 23 grams (0.05 pounds) after two weeks.
However, there were no significant differences in weight gain between four and six weeks after the start of therapy. And there was never a significant difference in average head circumference, which doctors also use to track babies' growth.
"Caffeine had the potentially adverse effect of diminishing weight gain for the first three weeks after the start of therapy," the researchers write. They add that caffeine didn't seem to affect death before the first discharge home, signs of brain injury as shown on ultrasound images, and infection and inflammation of the intestines (necrotizing enterocolitis).
Long-Term Results Not Out Yet
A longer follow-up is currently underway.
The study was designed to check whether premature babies that got caffeine therapy starting during the first 10 days after birth differed from those without caffeine therapy in death, cerebral palsycerebral palsy, cognitive delay, deafness, or blindness when they were approaching their second birthday.
The researchers write that the long-term results, including a follow-up when the babies are about 5 years old, "is needed before one can confidently recommend the standard use of methylxanthine therapy for apneaapnea of prematurity."
Methylxanthines are chemicals that include caffeine.
Bancalari's editorial notes that the babies in Schmidt's study got caffeine therapy earlier than many premature infants, who may have already suffered lung damage by the time they're started on caffeine. "It is unknown whether caffeine would protect against lung injury in this clinical setting, but it seems unlikely," Bancalari writes.