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Prophylactic Versus Therapeutic Caffeine for Apnea of Prematurity

Not Applicable
Completed
Conditions
Apnea
Interventions
Registration Number
NCT02677584
Lead Sponsor
Mansoura University Children Hospital
Brief Summary

Investigators hypothesized that the timing of caffeine administration in either prophylaxis or treatment of apnea of prematurity will affect the apnea response to caffeine

Detailed Description

It will be a randomized control trial, patients will be randomly assigned to receive caffeine in a loading dose of 20 mg/kg (equivalent to 10 mg/kg caffeine base) and a maintenance dose of 10 mg/kg/day (equivalent to 5 mg/kg caffeine base) either as a prophylaxis group (1) or therapeutic group (2). Prophylactic caffeine (group 1) will be defined as caffeine prescribed for preterm infants within the first 72 hours of life prior to manifest apnea , therapeutic caffeine ( group 2 ) will be defined as caffeine prescribed for manifest apnea within or after the first 72 hours of life .

Preparation and administration of caffeine will be performed by a Neonatal intensive care unit (NICU) nurse.

Statistical Evaluation:

Statistical analyses will be performed with the Statistical Package for Social Sciences-SPSS version 16 software (SPSS Inc, Chicago, Illinois). For categorical variables, the X2 test will be used. For group comparisons, the Student T test will be used in normal distribution and the Mann-Whitney U test will be used in case of abnormal distribution.

For repeating measurements, variance analyses and Friedman variance analyses will be used. For descriptive statistics, percent, minimum-maximum-median, mean, and standard deviation will be used in accordance with the type and distribution of the variable. A P value \<.05 was considered statistically significant. Informed consent will be obtained from parents, and the study will be approved by the local ethical committee.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
180
Inclusion Criteria
  • Infants eligible for this study will be newborn infants ≤ 32 weeks with or without a diagnosis of apnea .
Exclusion Criteria
  • Newborn infants with gestational age > 32 weeks.
  • Newborn infants with congenital malformations and chromosomal anomalies.
  • Newborn infants with apnea of other causes .

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Prophylactic caffeine citrateProphylactic caffeine citrateProphylactic caffeine (group1) will be defined as caffeine prescribed for preterm infant within the first 72 hours of life prior to manifest apnea . patients will be randomly assigned to receive caffeine in loading dose 20 mg/kg (equivalent for 10 mg/kg caffeine base) and maintenance dose 10 mg/kg/day (equivalent for 5 mg/kg caffeine base) .
Therapeutic caffeine citrateTherapeutic caffeine citrateTherapeutic caffeine ( group 2 ) will be defined as caffeine prescribed for manifest apnea within or after the first 72 hours of life . patients will be randomly assigned to receive caffeine in loading dose 20 mg/kg (equivalent for 10 mg/kg caffeine base) and maintenance dose 10 mg/kg/day (equivalent for 5 mg/kg caffeine base).
Primary Outcome Measures
NameTimeMethod
Duration of Respiratory Support60 days from NICU admission
Secondary Outcome Measures
NameTimeMethod
Days of apnea free60 days from NICU admission
length of hospital stay60 days from NICU admission
Head ultrasound results14 days from NICU admission

Any grade of intraventricular hemorrhage (IVH); periventricular leukomalacia (PVL)

Necrotizing Enterocolitis30 days from NICU admission

Any stage, according to modified Bell classification

Retinopathy of prematurity60 days from NICU admission

Any stage, according to International classification of retinopathy of prematurity (ICROP)

Trial Locations

Locations (1)

Mansoura University Children Hospital

🇪🇬

Mansoura, El Dakahlya, Egypt

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