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. 2023 Apr 11;2023(4):CD013873. doi: 10.1002/14651858.CD013873.pub2

Comparison 3. High‐ versus standard‐dose strategies for treatment of apnea.

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
3.1 All‐cause mortality prior to hospital discharge 3 333 Risk Difference (M‐H, Fixed, 95% CI) ‐0.03 [‐0.10, 0.04]
3.1.1 High‐loading and high‐maintenance dose versus standard‐loading and standard‐maintenance dose 2 169 Risk Difference (M‐H, Fixed, 95% CI) ‐0.02 [‐0.11, 0.07]
3.1.2 Standard‐loading and high‐maintenance dose versus standard‐loading and standard‐maintenance dose 1 164 Risk Difference (M‐H, Fixed, 95% CI) ‐0.04 [‐0.13, 0.06]
3.2 Failure to extubate within one week of commencing treatment 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
3.2.1 High‐loading and high‐maintenance dose versus standard‐loading and standard‐maintenance dose 1 78 Risk Ratio (M‐H, Fixed, 95% CI) 0.48 [0.24, 0.92]
3.3 Side effects (tachycardia, agitation, or feed intolerance) leading to a reduction in dose or withholding of caffeine 2   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
3.3.1 High‐loading and high‐maintenance dose versus standard‐loading and standard‐maintenance dose 2 150 Risk Ratio (M‐H, Fixed, 95% CI) 1.92 [0.53, 6.90]
3.4 Bronchopulmonary dysplasia/chronic lung disease at 36 weeks' postmenstrual age 3 333 Risk Ratio (M‐H, Fixed, 95% CI) 0.72 [0.47, 1.11]
3.4.1 High‐loading and high‐maintenance dose versus standard‐loading and standard‐maintenance dose 2 169 Risk Ratio (M‐H, Fixed, 95% CI) 0.75 [0.42, 1.35]
3.4.2 Standard‐loading and high‐maintenance dose versus standard‐loading and standard‐maintenance dose 1 164 Risk Ratio (M‐H, Fixed, 95% CI) 0.68 [0.36, 1.29]
3.5 Intraventricular hemorrhage, any grade 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
3.5.1 High‐loading and high‐maintenance dose versus standard‐loading and standard‐maintenance dose 1 49 Risk Ratio (M‐H, Fixed, 95% CI) 0.21 [0.03, 1.66]
3.6 Intraventricular hemorrhage, grade 3 to 4 2   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
3.6.1 High‐loading and high‐maintenance dose versus standard‐loading and standard‐maintenance dose 2 169 Risk Ratio (M‐H, Fixed, 95% CI) 1.14 [0.46, 2.82]
3.7 Periventricular leukomalacia 1 120 Risk Ratio (M‐H, Fixed, 95% CI) 1.25 [0.35, 4.43]
3.7.1 High‐loading and high‐maintenance dose versus standar‐loading and standard‐maintenance dose 1 120 Risk Ratio (M‐H, Fixed, 95% CI) 1.25 [0.35, 4.43]
3.8 Necrotizing enterocolitis (proven = Bell stage of 2 or greater) (Bell 1978) 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
3.8.1 High‐loading and high‐maintenance dose versus standard‐loading and standard‐maintenance dose 1 120 Risk Ratio (M‐H, Fixed, 95% CI) 0.67 [0.20, 2.24]
3.9 Retinopathy of prematurity (ROP) (any ROP) (International Committee 2005) 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
3.9.1 High‐loading and high‐maintenance dose versus standard‐loading and standard‐maintenance dose 1 49 Risk Ratio (M‐H, Fixed, 95% CI) 4.17 [0.50, 34.66]
3.10 Retinopathy of prematurity (ROP) (severe ROP [stage 3 or greater]) (International Committee 2005) 2   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
3.10.1 High‐loading and high‐maintenance dose versus standard‐loading and standard‐maintenance dose 2 169 Risk Ratio (M‐H, Fixed, 95% CI) 0.85 [0.29, 2.54]