High-dose caffeine citrate is more effective than low-dose caffeine citrate in the treatment of apnea of prematurity (AOP). The high-dose group showed fewer apnea episodes, higher extubation success rate, lower extubation failure rate and shorter duration of oxygen therapy

Apnea of prematurity (AOP) is a common condition in preterm infants due to immature respiratory control, affecting up to 80% of those under 1000 grams. It can lead to serious complications, including respiratory distress, pulmonary hemorrhage, and developmental delays. Caffeine citrate, a methylxanthine, is widely used for AOP treatment due to its longer half-life and better absorption compared to theophylline. However, the optimal dosage remains uncertain, with varying practices globally.

Inclusion Criteria:

• • Patients with a gestational age of ≥32 and <37 weeks at birth on LMP.

  • Diagnosis of apnea of prematurity (AOP) established as per operational definition within the first 10 days of life.
  • Either male or female patients

Exclusion Criteria:

• • Patients diagnosed with Hydrops fetalis (evaluated through medical record).

  • Patients presenting with major congenital or chromosomal anomalies such as anencephaly, spina bifida, congenital heart defects (e.g., tetralogy of Fallot, transposition of the great arteries), or chromosomal disorders (e.g., trisomy 18, Turner syndrome).
  • Presence of a confirmed sepsis through blood culture.
  • Presence of a significant underlying neurological disorder evaluated by history and medical records that could contribute to apnea (e.g., intraventricular hemorrhage with posthemorrhagic hydrocephalus, hypoxic-ischemic encephalopathy)
  • Patients who have been previously treated with caffeine or other methylxanthines for apnea.

Patient privacy will be our priority. Consent will be taken from patient for participation in study.