Early Initation Of Caffeine Citrate On Improving Assisted Ventilation In Very Low Birth Weight Infants

Background Caffeine citrate is a silver bullet in neonatology and trends to be used more and more earlier as widely used in clinical.Caffeine citrate is associated with a great reduction in duriation of ventilation in Very Low Birth Weight(VLBW)Infants,but it's benefits and safety should be assessed with different timing of caffeine therapy.Objective To investigate the effect of the early initation of caffeine citrate on improving assisted ventilation and clinical outcomes in VLBW infants.Methods We analyzes a retrospective cohort of 225 VLBW infants discharged between January 1,2015 to December 31,2016 in the NICUof Children'sHospital of Chongqing Medical Universerty.We divided 2 groups based on the following timing of caffeine initiation: with in first 2 days after birth(early)and on or after third day following birth(late).Duaration of assisted ventilation,gestational age of withdraw ventilation,recurrent ventilation rate,length of stay,hospitalization expenses,mortality,incidence of complications and adverse outcomes were observed.Result There were no statistically significant difference in clinical features and patients condition between 2 groups(P>0.05).Neonates in early group had a great reduction in duration of invasivemechanical ventilation(4d vs 8d,P<0.05);the early caffeine group trend to had a reduction in duration of positive pressure ventilation and duration of assisted ventilation,with a earlier gestational age of withdraw ventilation than late group,though there were no statistically significant difference.The early caffeine group had lower incidence rates of BPD?NEC and serious IVH but higher mortality than late caffeine group,but there were no statistically significant difference.While therewere statistically significant differenceon the duration of mechanical ventilation,on duration of positive pressure ventilation and the incidence ofserious IVH in the VLBW infants whoes birthweight>1250g(P<0.05).Conclusion Early initation of caffeine citrate is associated with a great reduction in duriation of invasive mechanical ventilation in VLBWInfants;It can be speculated that Early initation of caffeine citrate has the trend to decrease thetiming of CPAP?Incidence of servier IVH?BPD and NEC.Meanwhile,Large sample study are necessary to investigate thesecurity in the VLBW infants.