Caffeine therapy for very preterm infants in Australia and New Zealand: a bi-national survey
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 rece