Evidence map›Paper›PMID 15499141›Full record

Trial reportArchives of disease in childhood. Fetal and neonatal edition2004

High dose caffeine citrate for extubation of preterm infants: a randomised controlled trial.

P Steer, V Flenady, A Shearman, B Charles, P H Gray, D Henderson-Smart, G Bury, S Fraser, J Hegarty, Y Rogers and 6 more

Open access · bronzeAbstract readClinical TrialMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Archives of disease in childhood. Fetal and neonatal edition, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
56citing papers in PubMed, 5 pooled it
2.4field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

56 citing papers in PubMed, 5 syntheses or guidelines pooled it, 157 citations in OpenAlex.

  1. Caffeine for apnea and prevention of neurodevelopmental impairment in preterm infants: systematic review and meta-analysis.Journal of perinatology : official journal of the California Perinatal Association · 2024
    Pooled it
  2. Methylxanthine for the prevention and treatment of apnea in preterm infants.The Cochrane database of systematic reviews · 2023
    Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Trial
  7. Trial
  8. A Randomized Controlled Trial Comparing Two Doses of Caffeine for Apnoea in Prematurity.International journal of environmental research and public health · 2021
    Trial
  9. Trial
  10. Trial
  11. Trial
  12. Trial
  13. Trial
  14. Trial
  15. The effects of caffeine on heart rate variability in newborns with apnea of prematurity.Journal of perinatology : official journal of the California Perinatal Association · 2014
    Trial
  16. Effects of a divided high loading dose of caffeine on circulatory variables in preterm infants.Archives of disease in childhood. Fetal and neonatal edition · 2006
    Trial
  17. Article
  18. Review
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 5 institutions in 1 country.

P SteerDepartment of Neonatology and Centre for Clinical Studies, University of Queensland, Mater Health Services, South Brisbane, Australia.
V Flenady
A Shearman
B Charles
P H Gray
D Henderson-Smart
G Bury
S Fraser
J Hegarty
Y Rogers
S Reid
L Horton
M Charlton
R Jacklin
A Walsh
Caffeine Collaborative Study Group Steering Group
Mater Health Services · AUMercy Hospital for Women · AURoyal Hobart Hospital · AURoyal Prince Alfred Hospital · AUUniversity of Queensland · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo compare two dosing regimens for caffeine citrate in the periextubation period for neonates born at less than 30 weeks gestation in terms of successful extubation and adverse effects.

designA multicentre, randomised, double blind, clinical trial.

settingFour tertiary neonatal units within Australia. PATIENTS: Infants born less than 30 weeks gestation ventilated for more than 48 hours.

interventionsTwo dosing regimens of caffeine citrate (20 v 5 mg/kg/day) for periextubation management. Treatment started 24 hours before a planned extubation or within six hours of an unplanned extubation.

main outcome measureFailure to extubate within 48 hours of caffeine loading or reintubation and ventilation or doxapram within seven days of caffeine loading.

resultsA total of 234 neonates were enrolled. A significant reduction in failure to extubate was shown for the 20 mg/kg/day dosing group (15.0% v 29.8%; relative risk 0.51; 95% confidence interval (CI) 0.31 to 0.85; number needed to treat 7 (95% CI 4 to 24)). A significant difference in duration of mechanical ventilation was shown for infants of less than 28 weeks gestation receiving the high dose of caffeine (mean (SD) days 14.4 (11.1) v 22.1 (17.1); p = 0.01). No difference in adverse effects was detected in terms of mortality, major neonatal morbidity, death, or severe disability or general quotient at 12 months.

conclusionsThis trial shows short term benefits for a 20 mg/kg/day dosing regimen of caffeine citrate for neonates born at less than 30 weeks gestation in the periextubation period, without evidence of harm in the first year of life.

Indexed as

CaffeineCitratesDouble-Blind MethodDoxapramDrug CombinationsFemaleGestational AgeHumansInfant, NewbornInfant, PrematureMaleRespiration, ArtificialRespiratory System AgentsTime FactorsTreatment OutcomeVentilator WeaningCaffeinecaffeine citrateCitratesDoxapramDrug CombinationsRespiratory System Agents

Identifiers

PMID15499141
PMCPMC1721801
OpenAlexW2130355470

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.