Last updated 27 July 2021
Caffeine is
used to reduce apneic events in premature neonates. The current standard
treatment is based on an acceptable range of concentrations between 10 and 20
mg/L which is the same range recommended for theophylline for the treatment of
severe asthma. No concentration controlled study has been performed in neonates
to confirm this range.
A
prospective study of the pharmacokinetics of caffeine in premature neonates (Yang, Holford
et al. 2019) also collected data on the time to
event of apneic events (Holford, Yang
et al. 2019). The caffeine concentration
reducing the hazard of an apneic event by 50% was 1.8 mg/L with a predicted
maximum reduction of 49%. This predicts that a target concentration of 5 mg/L
would reduce the hazard by nearly 50%.
The
NextDose pharmacokinetic model is based on (Yang, Holford
et al. 2019).
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reserved | Developed by Sam Holford & Nick Holford 2012-2021
Holford, N., X. Yang, Z. Jiang, H. Shen, J. Shi, X. Shu, Y. Huang, J. Zhao, J. Tang and D. Mu (2019). "Rational dosing of caffeine using target concentration intervention to improve treatment of apnea of prematurity Abstr 9027 [www.page-meeting.org/?abstract=9027]." PAGE 28.
Yang, Y., N. Holford, Z. Jiang, H. Shen, J. Shi, X. Shu, Y. Huang, J. Zhao, J. Tang and D. Mu (2019). A Population Pharmacokinetic Study of Caffeine Citrate in Chinese Premature Neonates. PAGANZ. Auckland.