Objective: To explore the clinical efficacy of caffeine citrate combined with humidified high flow nasal cannula (HHFNC) in the treatment of recurrent apnea of prematurity (AOP) in premature infants. Methods: The clinical data of premature infants with recurrent apnea at gestational age from 30 to 34 weeks admitted from Jun. 2016 to Dec. 2017 were retrospectively analyzed. According to different treatment methods

all infants were divided into the HHFNC combined with caffeine citrate group and nasal continuous positive airway pressure (nCPAP) combined with caffeine citrate group. The treatment effects

adverse drug reactions

incidence of complications

length of stay and hospitalization cost were compared between two groups. The developmental screening test (DST) intelligence scale was performed at 40 weeks of corrected gestational age

and the difference of development quotient (DQ)/mental index (MI) was observed. Results: The incidence of nasal mucosal injury and abdominal distension in the HHFNC group was lower than that in the nCPAP group (P<0.05). The hospitalization cost in the HHFNC group was lower than that in the nCPAP group (P<0.05). There was no statistically significant difference in the effective rate of caffeine citrate combined with HHFNC in the treatment of recurrent AOP compared with the nCPAP group (P>0.05). There was no significant difference in the incidence of retinopathy of prematurity (ROP)

bronchopulmonary dysplasia (BPD)

intracranial hemorrhage and other complications between two groups (P>0.05). There was no statistically significant difference in DST intelligence scale DQ/MI between two groups at 40 weeks of corrected gestational age (P>0.05). Conclusion: The efficacy of caffeine citrate combined with HHFNC in the treatment of recurrent AOP is comparable to that of nCPAP

with low incidence of adverse drug reactions and low cost

while not affecting the early intellectual development of preterm infants

and HHFNC combined with caffeine citrate can be used as an effective treatment for recurrent AOP in preterm infants.