Efficacy of caffeine combined with non-invasive respiratory support on the treatment of apnea in very low birth weight preterm infants

Abstract

Objective To compare the efficacy and safety of caffeine combined with humidified high-flow nasal cannula (HHHFNC) and nasal continuous positive airway pressure (nCPAP) on the treatment of apnea in very low birth weight (VLBW) preterm infants. Methods Totally 80 VLBW preterm infants with neonatal apnea, who were enrolled in the NICU of Hebei Province Children Hospital from September 2013 to March 2014, were randomly assigned to either HHHFNC group (39 cases) or nCPAP group (41 cases) according to respiratory support mode by random number table method, both groups were given caffeine. The incidence of severe apnea, incidence of reintubation, oxygen exposure time, duration of non-invasive ventilation time, feeding conditions and incidence of adverse events were compared. Results There were no significant differences in male/female ratio, gestational age, age at randomization and birth weight between the two groups (P>0.05). There were no significant differences in the incidence of severe apnea[15.4% (6/39) vs 12.2% (5/41)], incidence of reintubation[17.9% (7/39) vs 19.5% (8/41)], oxygen exposure time [(183.1±31.2) h vs (175.9±32.1) h], duration of non-invasive ventilation time [(163.3±25.1) h vs (153.0±26.2) h] between the two groups (P>0.05). The occurrence of abdominal distention[7.7% (3/39) vs 24.4% (10/41)], nasal trauma[2.6% (1/39) vs 19.5% (8/41)], head shaping[0.0% (0/39) vs 29.3% (12/41)] during treatment were lower in HHHFNC group than those of nCPAP group (P<0.05). Age began feeding was earlier in HHHFNC group than nCPAP group [(67.5±19.1) h vs (96.3±18.7) h, P<0.05], and day to full oral feeding was reduced in HHHFNC group than nCPAP group [(346.8±28.6) h vs (371.0±29.4), P<0.05]. Conclusion HHHFNC combined with caffeine is effective on the treatment of apnea in VLBW preterm infants, and easier to make newborn tolerated. HHHFNC is an effective non-invasive respiratory support mode with few side effects. Key words: Very low birth weight preterm infants; Heated humidified high-flow nasal cannula; Nasal continuous positive airway pressure; Apnea; Caffeine