Medication Summary

Caffeine citrate is currently the medication used in NICUs to treat apnea of prematurity (AOP). The specific mechanism is not known, but caffeine citrate has been shown to act as a respiratory stimulant and allow infants to overcome the developmental immaturity that causes apnea or periodic breathing.^[36]

Unfortunately, patients with AOP have demonstrated various responses. A recent study has identified genetic markers (adenosine receptor gene polymorphisms) that may be able to predict an individual’s response to caffeine.^[37]

A study by Alansari et al aimed to determine the effectiveness of caffeine used for the treatment of apnea associated with bronchiolitis. It consisted of 90 infants diagnosed with viral bronchiolitis associated with apnea. It was found that unlike in AOP, a single dose of caffeine citrate did not significantly reduce apnea episodes associated with bronchiolitis.^[38]

Follow-up

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Author

Joshua A Rocker, MD Assistant Professor of Pediatrics and Emergency Medicine, Hofstra North Shore-LIJ School of Medicine; Associate Chief, Division of Pediatric Emergency Medicine, Director of Education for Pediatrics Emergency Medicine Fellowship, Cohen's Children Medical Center of New York

Joshua A Rocker, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Emergency Physicians

Disclosure: Nothing to disclose.

Coauthor(s)

Santina P Bruno, DO Fellow in Pediatric Emergency Medicine, Cohen Children's Medical Center, Northwell Health; Teaching Associate in Pediatrics, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell

Santina P Bruno, DO is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Wayne Wolfram, MD, MPH Professor, Department of Emergency Medicine, Mercy St Vincent Medical Center; Chairman, Pediatric Institutional Review Board, Mercy St Vincent Medical Center, Toledo, Ohio

Wayne Wolfram, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American Academy of Pediatrics, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Kirsten A Bechtel, MD Associate Professor of Pediatrics, Section of Pediatric Emergency Medicine, Yale University School of Medicine; Co-Director, Injury Free Coalition for Kids, Yale-New Haven Children's Hospital

Kirsten A Bechtel, MD is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Additional Contributors

Jeffrey Israel, MD Pediatric Emergency Medicine Fellow, Cohen Children's Medical Center of New York, North Shore-Long Island Jewish Health System

Jeffrey Israel, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors, Elizabeth B Jones, MD, Brent R King, MD, and Isaac Grate Jr, MD, to the development and writing of this article.

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