Abstract
Young infants with bronchiolitis commonly present with apnea. Caffeine is effective
in treating apnea of prematurity and has been used to treat apnea associated with
bronchiolitis.
To evaluate whether caffeine administration to infants presenting with apnea in the
setting of bronchiolitis was associated with a decreased rate of endotracheal intubation
and mechanical ventilation, compared to infants who did not receive caffeine. Retrospective
cohort study.
University affiliated tertiary care children's hospital. Twenty-eight infants less
than 3 months of age, 13 of whom received caffeine. Fewer infants who received caffeine
required endotracheal intubation and invasive mechanical ventilation (OR = 0.30 95%
CI 0.07 to 1.4, p = 0.15), but this was not statistically significant. Infants who received caffeine
were more likely to be treated with non-invasive ventilation than infants in the control
group (OR = 14; 95% CI 2.1 to 98 p = 0.01). Only one patient who was initially managed with non-invasive ventilation
was subsequently intubated. There was no difference in the duration of total respiratory
support, duration of invasive mechanical ventilation, hospital and pediatric critical
care unit stay. All infants survived. This study does not provide adequate evidence
to support or refute the routine use of caffeine in bronchiolitis associated apnea.
Keywords
Bronchiolitis - apnea - caffeine - respiratory syncytial virus - mechanical ventilation
- critical care
