Synonyms

Clinical Indications

Caffeine is used in neonates as a CNS stimulant to treat apnoea of prematurity. It is used in preference to theophylline since dose regimes are simpler, effects more predictable and toxicity is less of a problem. 
The reduced toxicity of caffeine and more predictable effects combine to reduce the need for therapeutic monitoring and a satisfactory clinical response can usually be obtained on standard dose regimes without the need for monitoring

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Combined Pathology Blood form (Yellow/Black)

Availability

Analysed by referral laboratory if specific criteria met.

Specific Criteria

Monitoring is rarely useful but may be valuable if response is inadequate despite apparently adequate dosing or if unexpected toxicity develops. Symptoms of toxicity in neonates include jitteriness and gastrointestinal disturbance.

Patient Preparation

Samples should preferably be collected pre-dose.

Turnaround Time

Up to 1 week.

Specimen

Plasma

Volume

1 ml

Container

Paediatric Lithium Heparin (Orange top). Yellow top (SST) tubes must not be used.

Lab. Handling

Aliquot and store at 4C. Samples should be posted as soon as possible.

Causes for Rejection

Not meeting specific criteria for analysis.

Reference Range

Target Range: 50 - 150 umol/L
In neonates with apnoea, pharmacological activity begins at plasma concentrations of 15 - 20 umol/L and concentrations in the range 25 - 100 umol/L are generally associated with improved respiration.

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