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Miao Y, Zhou Y, Zhao S, Liu W, Wang A, Zhang Y, Li Y, Jiang H. Comparative efficacy and safety of caffeine citrate and aminophylline in treating apnea of prematurity: A systematic review and meta-analysis. PLoS One 2022; 17:e0274882. [PMID: 36121807 PMCID: PMC9484669 DOI: 10.1371/journal.pone.0274882] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/06/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Methylxanthine, including caffeine citrate and aminophylline, is the most common pharmacologic treatment for apnea of prematurity. However, due to the lack of high-quality evidence, there are no clear recommendations or guidelines on how to choose between caffeine and aminophylline.
Objective
This meta-analysis aimed to assess the comparative efficacy and safety of caffeine and aminophylline for apnea of prematurity, and provide reliable evidence for clinical medication in the treatment for apnea of prematurity.
Methods
PubMed, Scopus, Embase, EBSCO, Web of Science, and Cochrane databases were systematically searched from May 1975 to June 2022.
Results
Ten studies including a total of 923 preterm infants were evaluated. Our results showed that there was no significant difference in the effective rate of 1-3days between caffeine and aminophylline (OR 1.05, 95%CI: 0.40–2.74, P = 0.914). However, for side effects such as tachycardia (OR 0.22, 95%CI: 0.13–0.37, P<0.001) and feeding intolerance (OR 0.40, 95%CI: 0.23–0.70, P = 0.001), the incidence rate was lower in the caffeine group compared with the aminophylline group. No significant difference was found in hyperglycemia (OR 0.45, 95%CI: 0.19–1.05, P = 0.064).
Conclusion
This meta-analysis reveals that caffeine citrate and aminophylline have similar therapeutic effectiveness on respiratory function, but caffeine has fewer side effects and should be considered first for treatment.
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Affiliation(s)
- Yiqun Miao
- School of Nursing, Weifang Medical University, Weifang, Shandong Province, China
| | - Yun Zhou
- School of Nursing, Weifang Medical University, Weifang, Shandong Province, China
| | - Shuliang Zhao
- School of Nursing, Weifang Medical University, Weifang, Shandong Province, China
| | - Wenwen Liu
- School of Nursing, Weifang Medical University, Weifang, Shandong Province, China
| | - Aihua Wang
- School of Nursing, Weifang Medical University, Weifang, Shandong Province, China
- * E-mail:
| | - Yuanyuan Zhang
- School of Nursing, Weifang Medical University, Weifang, Shandong Province, China
| | - Yanan Li
- School of Nursing, Weifang Medical University, Weifang, Shandong Province, China
| | - Huimin Jiang
- School of Nursing, Weifang Medical University, Weifang, Shandong Province, China
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