Neonatal Unit, James Cook University Hospital, Middlesbrough, UK.
Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
Acta Paediatr. 2023 Sep;112(9):1865-1869. doi: 10.1111/apa.16635. Epub 2022 Dec 23.
To understand the variations in practice for caffeine use among neonatal units in the United Kingdom.
An online survey was sent to every neonatal unit in the United Kingdom.
We received a response from 92 neonatal units (47%) with the proportion of response from special care, Local neonatal units, neonatal intensive care units and neonatal surgical units were 23%, 34%, 23% and 21% respectively. All the units reported the use of caffeine, and 40 units (46%) initiated caffeine within 24 h of birth. Fifty-nine units (64%) reported routine use of caffeine for pre-term infants <32 weeks. Seventy-one units (77%) reported that they continue caffeine for infants needing mechanical ventilation. Thirty-one units (34%) discontinued caffeine at 34 weeks post-menstrual age, irrespective of the respiratory support. Ten units (11%) reported discontinuation of caffeine only after weaning off all respiratory support, and 40% of units had a variable practice of discontinuing caffeine depending on the individual baby. Seventy-nine units (86%) reported they would regularly optimise caffeine dose based on weight checks.
Our survey showed some variation in practice with regards to the timing of caffeine initiation, gestational age cut-off for routine caffeine prescription and discontinuation.
了解英国新生儿单位中咖啡因使用实践的变化。
我们向英国的每一个新生儿单位发送了在线调查。
我们收到了 92 个新生儿单位（47%）的回复，其中来自特殊护理、本地新生儿单位、新生儿重症监护病房和新生儿外科单位的比例分别为 23%、34%、23%和 21%。所有单位均报告使用咖啡因，有 40 个单位（46%）在出生后 24 小时内开始使用咖啡因。59 个单位（64%）报告常规使用咖啡因治疗<32 周的早产儿。71 个单位（77%）报告他们继续为需要机械通气的婴儿使用咖啡因。31 个单位（34%）在胎龄 34 周后，不论呼吸支持如何，均停止使用咖啡因。10 个单位（11%）报告仅在停止所有呼吸支持后停止使用咖啡因，40%的单位根据个体婴儿的情况，有不同的停止使用咖啡因的做法。79 个单位（86%）报告他们将根据体重检查定期优化咖啡因剂量。
我们的调查显示，在咖啡因开始使用的时间、常规使用咖啡因的胎龄截止点和停止使用咖啡因方面存在一些实践差异。
