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Caffeine therapy for very preterm infants in Australia and New Zealand: a bi-national survey
  1. Tugba Alarcon Martinez1,
  2. Kate Alison Hodgson1,2,
  3. Elizabeth Baker1,2,
  4. Clare Whitehead2,3,
  5. Christopher Joel Dorman McKinlay4,5,
  6. Peter G Davis1,2,6,
  7. Brett James Manley1,2,6
  8. On behalf of the Australian and New Zealand Neonatal network (ANZNN)
  1. 1Newborn Research Centre, The Royal Women's Hospital, Melbourne, Victoria, Australia
  2. 2Department of Obstetrics, Gynaecology and Newborn Health, The University of Melbourne, Melbourne, Victoria, Australia
  3. 3Fetal Medicine Unit, The Royal Women's Hospital, Melbourne, Victoria, Australia
  4. 4Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
  5. 5Kidz First Neonatal Care, Te Whatu Ora Counties Manukau, Auckland, New Zealand
  6. 6Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
  1. Correspondence to Dr Brett James Manley, Newborn Research Centre, The Royal Women's Hospital, Parkville, Victoria, Australia; brett.manley{at}

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The largest randomised controlled trial (RCT) of neonatal caffeine therapy, the Caffeine for Apnea of Prematurity (CAP) trial, evaluated caffeine citrate at a loading dose of 20 mg/kg and a maintenance dose of 5–10 mg/kg/day.1 Although caffeine is among the most commonly used neonatal medications, practice varies widely, and higher dosing has been reported.2 We hypothesised that caffeine practice may have evolved since the last survey conducted in the Australian and New Zealand Neonatal Network (ANZNN),3 despite limited data supporting higher caffeine doses.2 We aimed to describe the current use of caffeine in very preterm infants as a fundamental step towards large RCTs of caffeine dosing.

A web-based 24-question survey was sent to 195 consultant neonatologists from 31 tertiary neonatal units within the ANZNN in March 2023. The survey inquired about the individual’s use of caffeine in preterm infants, including dosage and duration. Unit caffeine guidelines were also requested.

We received 117 (60%) individual …

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  • Contributors The research question for this study was conceived by BJM and developed by TAM, KAH and BJM. TAM undertook the data extraction and data analysis. TAM and KAH drafted the first draft of the manuscript. All authors were involved in interpretation, review and revision of the draft manuscript and approval of the final version. The authors had full access to the data in the study and take full responsibility for the integrity of the data and accuracy of the data analysis. The authors affirm that the manuscript is an honest, accurate and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned have been explained.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer-reviewed.