Cafeína como Terapia para Apneia da Prematuridade: Revisão de Evidências Clínicas
DOI:
https://doi.org/10.36557/2674-8169.2026v8n3p629-641Palavras-chave:
Apneia da Prematuridade; Cafeína; Distúrbios respiratórios; Pretermo; Metilxantinas.Resumo
A cafeína, a substância psicoativa mais consumida no mundo, tem sido estudada no tratamento da apneia da prematuridade (AOP), um distúrbio respiratório comum em bebês prematuros. Sua ação de antagonismo aos receptores de adenosina é percebida no sistema nervoso central, estimulando a oxigenação e contratilidade do diafragma. O objetivo dessa revisão foi analisar a eficácia do tratamento e possíveis efeitos colaterais nos prematuros. Foi realizada uma busca por trabalhos prévios nas plataformas PubMed e Biblioteca Virtual de Saúde (BVS), considerando os descritores “caffeine” e "apnea of prematurity". Vinte e dois (22) artigos foram incluídos após a aplicação dos critérios de inclusão e exclusão. Através dos estudos analisados foi observado que a maioria considerou a cafeína o tratamento mais eficaz para apneia em prematuros, enquanto um estudo indicou efeitos colaterais e eficácia limitada, e outro sugeriu eficácia similar à aminofilina. Em conclusão, a cafeína mostrou-se eficaz e segura no manejo clínico da apneia da prematuridade, mas não está isenta de riscos. Portanto, o uso dessa substância deve ser utilizado de acordo com protocolos pré estabelecidos.
Downloads
Referências
Dai HR, Guo HL, Hu YH, Xu J, Ding XS, Cheng R, et al. Precision caffeine therapy for apnea ofprematurity and circadian rhythms: New possibilities open up. Frontiers in Pharmacology [Internet].2022 [cited 2023 Jun 1];13:1053210.
Oliphant EA, Hanning SM, McKinlay CJD, Alsweiler JM. Caffeine for apnea and prevention of neurodevelopmental impairment in preterm infants: systematic review and meta-analysis. Journal ofPerinatology [Internet]. 2024 Jun 1 [cited 2024 Jul 16];44(6):785– 801.
Pergolizzi J, Kraus A, Magnusson P, Breve F, Mitchell K, Raffa R, et al. Treating Apnea of Prematurity. Cureus. 2022 Jan 31;14(1).
Schoen K, Yu T, Stockmann C, Spigarelli MG, Sherwin CMT. Use of Methylxanthine Therapiesfor the Treatment and Prevention of Apnea of Prematurity. Pediatric Drugs. 2014 Jan 8;16(2):169–77.
Schmidt B, Roberts RS, Davis P, Doyle LW, Barrington KJ, Ohlsson A, et al. Caffeine Therapy for Apnea of Prematurity. New England Journal of Medicine. 2006 May 18;354(20):2112–21.
Ozkan H, Cetinkaya M, Cakir SC, Saglam O, Koksal N. Effects of Different Onset Times of Early Caffeine Treatment on Mesenteric Tissue Oxygenation and Necrotizing Enterocolitis: A Prospective, Randomized Study. Am J Perinatol. 2023 Jan;40(1):28-34.
Dani C, Cecchi A, Ciarcià M, Miselli F, Luzzati M, Remaschi G, et al. Enteral and Parenteral Treatment with Caffeine for Preterm Infants in the Delivery Room: A Randomised Trial. Paediatr Drugs. 2023 Jan;25(1):79-86. Epub 2022 Oct 27. Erratum in: Paediatr Drugs. 2024 Mar;26(2):215.
Jiang Q, Wu X. Effect of early preventive use of caffeine citrate on prevention together with treatment of BPD within premature infants and its influence on inflammatory factors. Biotechnol Genet Eng Rev. 2023;1–15.
Bruschettini M, Brattström P, Russo C, Onland W, Davis PG, Soll R. Caffeine dosing regimens in preterm infants with or at risk for apnea of prematurity. Cochrane Database Syst Rev. 2023 Apr 11;4(4):CD013873.
Iranpour R, Armanian AM, Miladi N, Feizi A. Effect of Prophylactic Caffeine on Noninvasive Respiratory Support in Preterm Neonates Weighing 1250-2000 g: A Randomized Controlled Trial. Arch Iran Med. 2022 Feb 1;25(2):98-104.
Sajjadian N, Taheri PA, Jabbari M. Is Early Preventive Caffeine Safe and Effective in Premature Neonates? A Clinical Trial. Int J Pediatr. 2022 Jun 2;2022:8701598.
Prakash R, Pournami F, Prabhakar J, Nandakumar A, Nair PMC, Jain N. Duration of Caffeine for Apnea of Prematurity-A Randomized Controlled Trial. Indian Journal of Pediatrics [Internet]. 2021 Dec 1;88(12):1174–9.
Elmowafi M, Mohsen N, Nour I, Nasef N. Prophylactic versus therapeutic caffeine for apnea of prematurity: a randomized controlled trial. J Matern Fetal Neonatal Med. 2022 Dec;35(25):6053-61.
Kori AMM, Rostenberghe HV, Ibrahim NR, Yaacob NM, Nasir A. A Randomized Controlled Trial Comparing Two Doses of Caffeine for Apnoea in Prematurity. Int J Environ Res Public Health. 2021 Apr 23;18(9):4509.
Li XL, Cai YJ, Zhang Z, Li J, Chen XW, Song YY, et al. Effect of different maintenance doses of caffeine citrate on ventilator weaning in very preterm infants with respiratory distress syndrome: a prospective randomized controlled trial. Zhongguo Dang Dai Er Ke Za Zhi. 2021 Nov 15;23(11):1097-102.
Abdel Mageed ASA, Olama KA, Abdel Rahman SA, El-Gazzar HE. The effect of sensory stimulation on apnea of prematurity. J Taibah Univ Med Sci. 2021 Dec 10;17(2):311-9.
Duchamp-Viret P, Nguyen HK, Maucort-Boulch D, Remontet L, Guyon A, Franco P, et al. Protocol of controlled odorant stimulation for reducing apnoeic episodes in premature newborns: a randomised open-label Latin-square study with independent evaluation of the main endpoint (PREMODEUR). BMJ Open. 2021 Sep 13;11(9).
Wan L, Huang L, Chen P. Caffeine citrate maintenance doses effect on extubation and apnea postventilation in preterm infants. Pediatr Pulmonol. 2020 Oct;55(10):2635-40.
He T, Liao ZC, Ding Y, Wang MJ, Li W, Gan JM, et al. [Comparison of the efficacy of domestic and imported caffeine citrate in the treatment of apnea in preterm infants: a prospective randomized double-blind controlled trial]. Zhongguo Dang Dai Er Ke Za Zhi. 2020 Jul;22(7):684-9.
Oliphant EA, McKinlay CJD, McNamara DG, Alsweiler JM. (Rad 8)Caffeine prophylaxis to improve intermittent hypoxaemia in infants born late preterm: a randomised controlled dosage trial (Latte Dosage Trial). BMJ Open. 2020 Oct 20;10(10):e038271. Erratum in: BMJ Open. 2020 Nov 6;10(11):1
Du L, Tong X, Chen C, Gao X, Gagnatelli A, Li J, et al. Caffeine Citrate for Apnea of Prematurity: A Prospective, Open-Label, Single-Arm Study in Chinese Neonates. Front Pediatr. 2020 Mar 11;8:76.
Zhang X, Zhang HT, Lyu Y, Wang LF, Yang ZY. [Clinical effect and safety of different maintenance doses of caffeine citrate in treatment of apnea in very low birth weight preterm infants: a prospective randomized controlled trial]. Zhongguo Dang Dai Er Ke Za Zhi. 2019 Jun;21(6):558-61.
Puia-Dumitrescu M, Smith PB, Zhao J, Soriano A, Payne EH, Harper B, et al. Dosing and Safety of Off-label Use of Caffeine Citrate in Premature Infants. J Pediatr. 2019 Aug;211:27-32.
Zulqarnain A, Hussain M, Suleri KM, Ch ZA. Comparison of Caffeine versus Theophylline for apnea of prematurity. Pak J Med Sci. 2019 Jan-Feb;35(1):113-6.
Jain V, Saroha V, Patel RM, et al. Is early caffeine therapy safe and effective for ventilated preterm infants? J Perinatol. 2019;39:754-7.
Shivakumar M, Nayak K, Lewis LES, Kamath A, Purkayastha J. Acute hemodynamic effects of methylxanthine therapy in preterm neonates: effect of variations in subgroups. J Trop Pediatr. 2019 Jun;65(3):264-72.
Kou C, Han D, Li Z, Wu W, Liu Z, Zhang Y, Gao Z. Influence of prevention of caffeine citrate on cytokine profile and bronchopulmonary dysplasia in preterm infants with apnea. Minerva Pediatr. 2020 Apr;72(2):95-100.
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2026 João Vitor Macedo de Oliveira, Luan Gabriel Affonso, Milla Daudt Ribeiro, Maria Victória da Costa Farfan, Ana Clara Pinheiro Andrade, Paula Kling Ramalho

Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
Os autores são detentores dos direitos autorais mediante uma licença CCBY 4.0.



