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首页> 外文期刊>The New England journal of medicine >Caffeine therapy for apnea of prematurity.
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Caffeine therapy for apnea of prematurity.

机译：咖啡因疗法可治疗早产儿呼吸暂停。

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BACKGROUND: Methylxanthines reduce the frequency of apnea of prematurity and the need for mechanical ventilation during the first seven days of therapy. It is uncertain whether methylxanthines have other short- and long-term benefits or risks in infants with very low birth weight. METHODS: We randomly assigned 2006 infants with birth weights of 500 to 1250 g during the first 10 days of life to receive either caffeine or placebo, until drug therapy for apnea of prematurity was no longer needed. We evaluated the short-term outcomes before the first discharge home. RESULTS: Of 963 infants who were assigned to caffeine and who remained alive at a postmenstrual age of 36 weeks, 350 (36 percent) received supplemental oxygen, as did 447 of the 954 infants (47 percent) assigned to placebo (adjusted odds ratio, 0.63; 95 percent confidence interval, 0.52 to 0.76; P<0.001). Positive airway pressure was discontinued one week earlier in the infants assigned to caffeine (median postmenstrual age, 31.0 weeks; interquartile range, 29.4 to 33.0) than in the infants in the placebo group (median postmenstrual age, 32.0 weeks; interquartile range, 30.3 to 34.0; P<0.001). Caffeine reduced weight gain temporarily. The mean difference in weight gain between the group receiving caffeine and the group receiving placebo was greatest after two weeks (mean difference, -23 g; 95 percent confidence interval, -32 to -13; P<0.001). The rates of death, ultrasonographic signs of brain injury, and necrotizing enterocolitis did not differ significantly between the two groups. CONCLUSIONS: Caffeine therapy for apnea of prematurity reduces the rate of bronchopulmonary dysplasia in infants with very low birth weight. (ClinicalTrials.gov number, NCT00182312.).
机译：背景：在治疗的前7天，甲基黄嘌呤减少了早产呼吸暂停的频率，并减少了机械通气的需要。尚不确定甲基黄嘌呤在出生体重很低的婴儿中是否还有其他短期和长期的益处或风险。方法：我们随机分配2006年出生体重在500至1250 g之间的婴儿，在其出生后的前10天接受咖啡因或安慰剂，直到不再需要药物治疗早产呼吸暂停。我们评估了第一次出院前的短期结果。结果：在分配有咖啡因并在月经后36周存活的963例婴儿中，有350例（36％）接受了补充氧气，而分配给安慰剂的954例婴儿中有447例（47％）接受了补充氧气（调整后的比值比， 0.63; 95％置信区间，0.52至0.76; P <0.001）。与安慰剂组婴儿相比，经咖啡因分娩的婴儿（经期中位数为31.0周;四分位数范围为29.4至33.0）提前一个星期停止了正气道压力（经期中位数为32.0周;四分位数范围为30.3至3.00）。 34.0; P ＜0.001）。咖啡因可暂时减轻体重增加。接受咖啡因的组和接受安慰剂的组之间体重增加的平均差异在两周后最大（平均差异为-23 g; 95％置信区间为-32至-13; P <0.001）。两组的死亡率，脑损伤的超声检查迹象和坏死性小肠结肠炎的发生率无显着差异。结论：咖啡因治疗早产儿呼吸暂停可降低极低出生体重婴儿的支气管肺发育不良率。 （ClinicalTrials.gov编号，NCT00182312。）。

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