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Caffeine – supports extubation — RACP Paediatrics MCQ

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EasyNeonatalCaffeine – supports extubationRACP Paediatrics

A premature infant has been treated with surfactant and stabilised on mechanical ventilation. The aim is to extubate to CPAP within hours. What is the most important pharmacological intervention to reduce extubation failure?

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Correct answer: C — Mechanical ventilation

Caffeine citrate is the most important pharmacological intervention to support extubation in preterm infants. The CAP trial demonstrated that early caffeine reduces BPD, shortens ventilation duration, and improves neurodevelopment. Loading dose 20 mg/kg caffeine citrate, maintenance 5-10 mg/kg/day. It should be given before or at the time of extubation.

Reference: RCH Melbourne – 2023 – Apnoea CPG; Schmidt – CAP Trial