Category: Pediatrics
Keywords: caffeine, bronchiolitis, respiratory distress (PubMed Search)
Posted: 10/17/2025 by Jenny Guyther, MD
(Updated: 12/5/2025)
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Premature infants in the NICU are often given caffeine to help to prevent apneic episodes and this has been proven safe. This study aims to determine if caffeine will help infants < 8 weeks with bronchiolitis, even if there is no concern for apnea. The current recommended treatment for bronchiolitis is supportive care.
2 French Hospitals with the same protocols and resources for bronchiolitis participated. All infants admitted to each hospital with a diagnosis of bronchiolitis were included. Infants who presented to Hospital A received caffeine and infants who presented to hospital B did not. The remainder of their care was similar. The caffeine was given as a bolus dose followed by a daily maintenance dose until there was clinical improvement. The dose was the standard dose used in premature infants with apnea as recommended by the French National Authority for Health. There were 26 patients at the study hospital that did not receive caffeine for an unknown reason. 65 patients received caffeine.
The study had several areas showing statistical significance:
In the subgroup of RSV + patients, those who did NOT receive caffeine had a higher incidence of requiring ventilatory support.
The use of high flow nasal cannula was HIGHER in the group with NO caffeine.
The use of CPAP was HIGHER in the caffeine group BUT the duration of CPAP use was shorter compared to the NO caffeine group.
The need for nutritional support was higher in the NO caffeine group.
There were a few cases of temporary tachycardia and irritability in the caffeine group which resolved several hours after the medication was given.
A larger study is needed, but in this small group, there may be an indication for caffeine outside of the NICU for infants < 8 weeks.
Casabianca M, Akouka D, Maman L, Lopes AA. Caffeine Was Associated With Shorter Continuous Positive Airway Pressure Treatment for Infants up to Eight Weeks Old Hospitalised for Bronchiolitis. Acta Paediatr. 2025 Aug 27. doi: 10.1111/apa.70279. Epub ahead of print. PMID: 40862534.
