Higher versus Standard Caffeine dosing in Prevention of Apnoea of Prematurity: A Randomized Controlled Trial (HI-CAF trial)

Our study, titled "Higher versus Standard Caffeine dosing in Prevention of Apnoea of Prematurity (HI-CAF trial)," investigates the efficacy of a higher dose of caffeine in reducing Apnea of Prematurity (AoP) compared to standard dosing. With a global rise in premature births, the research addresses the need for optimal management, particularly in low- and middle-income countries. The study design is a randomized controlled trial conducted in an Indian neonatal unit, focusing on neonates below 32 weeks gestation. The primary outcome is the proportion of Apnoea of Prematurity, with secondary outcomes including the rates of  failure of extubation, Incidence of PDA, NEC, IVH, PVL, ROP and AKI, Duration of respiratory support,

The time to reach full enteral feeding, Number of NPO hours, The incidence of Hypertension,

Growth velocities( average weekly weight gain in first month of life and average weight gain during NICU stay), The incidence of Seizures, Severe adverse events, BPD and Mortality. The methodology involves randomization into higher and standard dose caffeine groups, and the study aims to contribute valuable insights to the inconsistent data on caffeine dosing. The study period is for 18 months, and the statistical analysis will employ chi-square tests and t-tests, presenting results with a significance threshold of p < 0.05. The study seeks to address gaps in literature, particularly in the context of limited evidence from low- and middle-income countries, and aims to provide practical implications for neonatal care.