الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
During the first few days of life, premature infants encounter problems with normal control of respiration making AOP one of the most common complications of prematurity. Approximately 70% of babies born before 34 weeks’ gestation have clinically significant apnea, bradycardia, or O2 desaturation during their hospital stay.
Caffeine citrate has been considered the top of all drugs used in NICUS for prophylaxis and treatment of AOP. Its use extends to involve other neonatal morbidities as decreased incidence of BPD and PDA requiring treatment in VLBW infants. Many NICUs have changed their practice towards earlier initiation of caffeine therapy.
The aim of our study was to determine the effect of early initiation of caffeine therapy on neonatal outcome in preterm infants.
This study was conducted on 50 preterm neonates < 32 weeks and <2 kg diagnosed as having respiratory distress.
Cases were divided into 2 groups; early (administered caffeine within the first 2 days of life) and late (administered caffeine after the second day of life).
The early group included 25 newborns; 64% males and 36% females, with mean gestational age of (30.24 ± 1.33) weeks, mean birth weight of (1.56 ± 0.51) kg.
The late group included 25 newborns; 56% males and 44% females, with mean gestational age of (30.52 ±1.12) weeks, mean birth weight of (1.51 ± 0.50)kg.
In the early group, 60% neonates were delivered by cesarean section, and 40% vaginally. In the late group, 56% neonates were delivered by cesarean section, and 44% vaginally.
In the early group, 24% neonates were of multiple gestation and mothers of 84% neonates received antenatal steroids. In the late group, 28% neonates were of multiple gestation and mothers of 76% neonates received antenatal steroids.
All studied neonates were subjected to the following:
1. Full history taking
2. through clinical examination
3. laboratory investigations: done according to case condition as CBC, CRP, ABG, serum sodium, serum potassium, serum calcium, random blood sugar, urea, creatinine, SGOT, SGPT, Blood culture.
4. Imaging procedures: done as needed as chest or abdominal X-ray, abdominal or cranial US, fundus examination.
5. Follow up till discharge from NICU.
Statistical tests were done to determine whether early caffeine administration was effective on neonatal outcome.
Results of our study were:
Intubation increased in infants received caffeine late starting from the second day of life, however, CPAP use increased in infants received caffeine early.
As regard mean duration of mechanical ventilation and total O2 duration, they significantly increased in the late group.