ReviewPediatric research2026
Caffeine and preterm infants: multiorgan effects and therapeutic creep: scope to optimise dose and timing.
Review in Pediatric research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
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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.
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.
Who cites it
7 citing papers in PubMed.
- Why leave neonatal therapies up to chance?Pediatric research · 2026Article
- Caffeine addiction: optimising neonatal caffeine use.Pediatric research · 2026Article
- Dosing practices of caffeine therapy for apnoea of prematurity: a retrospective single-centre observational study.BMJ paediatrics open · 2026Observational
- The Link Between Preterm Birth and Long-Term Renal Consequences: Current Knowledge and Emerging Therapeutic Targets.Biomedicines · 2026Review
- Association Between Serum Caffeine Concentrations, Intermittent Hypoxia and Apnea in Preterm Infants: A Prospective Observational Study.Children (Basel, Switzerland) · 2026Article
- Caffeine Protects Against Hyperoxia-Induced Structural Lung Injury and Restores Alveolar Development in Neonatal Rats.Antioxidants (Basel, Switzerland) · 2025Article
- Pharmacological treatment for apnoea of prematurity-the need for an individualised approach.Frontiers in pediatrics · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
19 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Caffeine is a methylxanthine used for nearly 50 years in the treatment of apnoea of prematurity (AOP). Caffeine citrate is effective in the treatment of AOP using standard dosing (loading dose 20 mg/kg, maintenance 5-10 mg/kg/day) and is associated with long-term neurological benefits and other improved organ outcomes as well as immunomodulatory effects. Therapeutic creep has been noted in the use of caffeine in preterm infants differing from the criteria in randomised controlled trials. A Cochrane review showed insufficient evidence to support prophylactic use of caffeine citrate in preterm neonates to prevent AOP, although it is still recommended in many national and local guidelines. Concerns about adverse reactions exist with high-dose caffeine regimens with one high-dose trial reporting statistically significant increases in abnormal neurological outcomes compared with standard doses (80 mg/kg compared to 20 mg/kg). International clinical guidelines vary from clinical trials regarding timing, dose, and duration of caffeine therapy. Further clinical research could help to understand optimal doses for different indications, such as peri-extubation, early postnatal use while ventilated, multiorgan and psychoactive effects, and long-term neurodevelopmental outcomes. This review describes the mechanism and multiorgan effects of caffeine highlighting areas of therapeutic creep and uncertainty requiring further research, such as comparative effectiveness trials. IMPACT: Caffeine citrate is indicated for the management of apnoea of prematurity. Therapeutic creep is evident in international guidelines for the use of caffeine citrate in preterm infants. Caffeine has multiorgan effects involving renal, respiratory, and inflammatory responses, which, by optimising dosing and timing, may improve outcomes. Optimising indications, dose, and timing of caffeine citrate in preterm infants in further large-scale trials is warranted and may have other multiorgan benefits.
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