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Caffeine and preterm babies’ kidneys
In the July edition of FNN, Hyperion noted that the benefit of caffeine for preterm babies in the CAP trial could still be demonstrated 11 years later. But Hyperion had not previously been aware of the ‘Assessment of Worldwide Acute Kidney Injury Epidemiology in Neonates’ (AWAKEN) study (JAMA Pediatr 2018;172:e180322): from this multicentre, multinational observational cohort, a secondary analysis of 675 babies revealed that caffeine was associated with a significantly lower risk of acute kidney injury in the first postnatal week. If this relationship were causal, and caffeine were proved to be protective against AKI, the number needed to treat would be about 4.
The abbreviation is GER or GOR, depending on your linguistic heritage. Either way, reflux is nearly universal in preterm babies, but opinion on whether it is a ‘problem’, and practice with regards to ‘treatment’, vary considerably between neonatal services; and within them, between individual doctors and nurses. Objective evidence is a bit thin, so in Hyperion’s experience opinions are held forcefully. Hyperion was therefore delighted to see that a working group on behalf of the …