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Caffeine for preterm infants: a narrative review

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Caffeine is an adenosine receptor antagonist used to prevent or treat apnea of prematurity in the neonatal period and is now the standard of care for very low birth weight infants. Caffeine is a widely used stimulant that has been shown to reduce the duration of assisted ventilation and oxygen therapy in the short term, as well as the rate of treatment for patent ductus arteriosus and bronchopulmonary dysplasia. In the longer term, it improves expiratory airflow in children and has benefits for respiratory health. These results are due to several effects of caffeine. It stimulates the respiratory center in the brain stem and improves diaphragm contractility. In addition, caffeine protects against lung inflammation caused by lipopolysaccharide-induced pro-inflammatory amnionitis and has direct effects on pneumocytes and pulmonary angiogenesis, thereby reducing hyperoxia-induced lung injury. It also has antifibrotic activity in lung tissue. Caffeine improves survival without neurodevelopmental disability at 18 months and has demonstrated long-term safety up to 11 years of age.The present article is a non-exhaustive review of useful information about one of the most commonly used drugs in neonatal medicine.

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Nascer e Crescer - Birth and Growth Medical Journal 2023;32(4):289-298. doi:10.25753/BirthGrowthMJ.v32.i4.27860

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Centro Hospitalar Universitário de Santo António

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