Systematically Review on Effect of Caffeine at Different Starting Times on Prevention and Treatment of Apnea in Very Low Birth Weight Preterm Infants

Lei Jufang; Chen Wenchao; Zhang Yong; Yin Huan

doi:10.13407/j.cnki.jpp.1672-108X.2022.12.011

您当前的位置：

首页 >

文章列表页 >

Systematically Review on Effect of Caffeine at Different Starting Times on Prevention and Treatment of Apnea in Very Low Birth Weight Preterm Infants

更新时间：2023-04-16

- Systematically Review on Effect of Caffeine at Different Starting Times on Prevention and Treatment of Apnea in Very Low Birth Weight Preterm Infants
- Vol. 28, Issue 12, Pages: 39-43(2022)
- 作者机构：
  
  鄂东医疗集团黄石市妇幼保健院,湖北,黄石,435000
- 作者简介：
- 基金信息：
- DOI：10.13407/j.cnki.jpp.1672-108X.2022.12.011
  CLC：
- Published：2022，
扫描看全文
Lei Jufang, Chen Wenchao, Zhang Yong, et al. Systematically Review on Effect of Caffeine at Different Starting Times on Prevention and Treatment of Apnea in Very Low Birth Weight Preterm Infants. [J]. 28(12):39-43(2022)
DOI：

Lei Jufang, Chen Wenchao, Zhang Yong, et al. Systematically Review on Effect of Caffeine at Different Starting Times on Prevention and Treatment of Apnea in Very Low Birth Weight Preterm Infants. [J]. 28(12):39-43(2022) DOI： 10.13407/j.cnki.jpp.1672-108X.2022.12.011.

摘要

目的：探讨不同起始时间使用咖啡因防治极低出生体质量早产儿呼吸暂停的疗效和安全性。方法：检索PubMed、Cochrane Library、Embase、中国期刊全文数据库（CNKI）、万方数据、生物医学文献（CBM）及维普等数据库，收集各数据库从建库至2020年6月有关极低出生体质量早产儿早期应用咖啡因防治呼吸暂停的病例对照研究，并采用Cochrane系统评价手册5.1.0和Newcastle-Ottawa量表（NOS）对不同类型研究进行质量评价，采用RevMan 5.3进行系统评价。结果：10项文献中，包括5项随机临床对照研究（RCT）和5项回顾性队列研究，文献质量评价结果显示，5项RCT质量等级为B级，5项回顾性队列研究NOS评分为7～9分。共2 665例患儿，其中早期用药组1 515例，晚期用药1 150例。Meta分析结果显示，早期用药组呼吸暂停（AOP）发生率（RR=0.48，95%CI 0.38～0.60，P<0.01）、吸氧时间（SMD=－0.97，95%CI －1.13～－0.80，P<0.01）、机械通气时间（SMD=－0.82，95%CI －1.06～－0.58，P<0.01）、咖啡因用药时间（SMD=－0.42，95%CI －0.56～－0.28，P<0.01）、支气管肺发育不良（BPD）发生率（RR=0.50，95%CI 0.41～0.60，P<0.01）、动脉导管未封闭（PDA）发生率（RR=0.56，95%CI 0.44～0.70，P<0.01）、早产儿视网膜病（ROP）发生率（RR=0.59，95%CI 0.47～0.74，P<0.01）、脑室内出血（IVH）发生率（RR=0.66，95%CI 0.54～0.81，P<0.01）和坏死性小肠结肠炎（NEC）发生率（RR=0.70，95%CI 0.55～0.91，P<0.01）显著低于晚期用药组，而病死率（RR=1.15，95%CI 0.73～1.81，P=0.55）与晚期用药组比较差异无统计学意义。结论：极低出生体质量早产儿早期使用咖啡因能显著降低呼吸暂停发生率、BPD、ROP、PDA、IVH和NEC发生率，减少机械通气、吸氧和咖啡因用药时间，但对病死率无影响。

Abstract

Objective: To probe into the clinical efficacy and safety of caffeine at different starting times on prevention and treatment of apnea in very low birth weight preterm infants. Methods: PubMed

the Cochrane Library

EMBase

CNKI

Wanfang

CMB and VIP database were retrieved to collect the case-control study of caffeine at different starting times on prevention and treatment of apnea in very low birth weight preterm infants. The retrieval time was from the establishment of the database to Apr. 2020. Quality of different types of studies was evaluated by using Cochrane Handbook 5.1.0 and Newcastle Ottawa scale (NOS)

RevMan 5.3 was used for Meta-analysis. Results: A total of 10 studies were enrolled

including 5 randomized controlled trials (RCT) and 5 retrospective cohort studies. Results of the literature quality evaluation showed that 5 RCT were of grade B

and 5 retrospective cohort studies had the NOS score from 7 to 9 points. A total of 2

665 children were included

with 1

515 cases in the early administration group and 1

150 cases in the late administration group. Meta-analysis showed that the incidence of apnea (AOP) (RR=0.48

95%CI from 0.38 to 0.60

P<0.01)

duration of oxygen inhalation (SMD=-0.97

95%CI from -1.13 to -0.80

P<0.01)

mechanical ventilation time (SMD=-0.82

95%CI from -1.06 to -0.58

P<0.01)

caffeine administration time (SMD=-0.42

95%CI from -0.56 to -0.28

P<0.01)

incidence of bronchopulmonary dysplasia (BPD) (RR=0.50

95%CI from 0.41 to 0.60

P<0.01)

incidence of patent ductus arteriosus (PDA) (RR=0.56

95%CI from 0.44 to 0.70

P<0.01)

incidence of retinopathy of prematurity (ROP) (RR=0.59

95%CI from 0.47 to 0.74

P<0.01)

incidence of intraventricular hemorrhage (IVH) (RR=0.66

95%CI from 0.54 to 0.81

P<0.01) and incidence of necrotizing enterocolitis (NEC) (RR=0.70

95%CI from 0.55 to 0.91

P<0.01) in early administration group were significantly lower than that those in late administration group

while the mortality (RR=1.15

95%CI from 0.73 to 1.81

P=0.55) was not significantly different. Conclusion: Early administration of caffeine in very low birth weight preterm infants can significantly reduce the incidence of AOP

BPD

ROP

PDA

IVH and NEC

and shorten the mechanical ventilation time

duration of oxygen inhalation and caffeine administration time

which has no effect on mortality.

关键词

咖啡因极低出生体质量早产儿呼吸暂停Meta分析

Keywords

caffeineery low birth weightpremature infantsapneaMeta-analysis

references

查看原文

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Determination of Caffeine Blood Concentration in Neonates by High Performance Liquid Chromatography and Its Clinical Application

Meta-Analysis of Efficacy and Safety of Different Drug Administration Routes for the Treatment of Premature Infants with Patent Ductus Arteriosus

Meta-Analysis of Efficacy and Safety of Milrinoneon Injection in the Treatment of Children with Congenital Heart Disease Complicated with Severe Pneumonia and Heart Failure

Meta-Analysis of Probiotics in the Treatment of Functional Abdominal Pain in Children

Meta-Analysis on Efficacy of Triple Therapy Combined with Synbiotics in Eradication of Helicobacter Pylor

Related Author

Su Lingying

Li Shoulin

Li Sai

Hua Ziyu

Sun Jian

Shen Yue

Xiang Lingling

Zhang Dufei

Related Institution

The Affiliated Huai’an No. 1 People’s Hospital of Nanjing Medical University, Jiangsu Huai’an

Huai’an Women and Children’s Health Care Hospital, Jiangsu Huai’an

Children’ s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics

Hainan Women and Children’s Medical Center, Children’s Hospital of Hainan

Department of Pediatrics, China-Japan Friendship Hospital

⁰