Efficacy of caffeine citrate combined with INSURE in treating neonatal respiratory distress syndrome
GAO Xu
DENG Shuxian
BIAN Sitao
CUI Ni
WU Xinwei
Abstract：Objective To explore the efficacy of caffeine citrate combined with the intubation-surfactant-extubation(INSURE)technique in the treatment of neonatal respiratory distress syndrome(NRDS)and its impact on blood gas analysis parameters.Methods A prospective randomized controlled trial was conducted.A total of 328 neonates with NRDS admit-ted to Xianyang Rainbow Hospital from January 2024 to August 2025 were collected and randomly divided into the combined group and the control group using a random number table,with 164 cases in each group.The control group was treated with INSURE,while the combined group was additionally given caffeine citrate.Treatment lasted for 7 days.The clinical efficacy,treatment outcomes,blood gas analysis parameters,serological indicators,and incidence of adverse reactions(including bron-chopulmonary dysplasia,pulmonary hemorrhage,pulmonary infection,etc.)were compared between the control group and the combined group.Results The total effective rate was higher in the combined group(94.51%,155/164)than in the control group(88.41%,145/164)(χ2=3.905,P<0.05).The duration of oxygen therapy and hospitalization in the combined group((89.19±13.11)h,(21.31±5.26)d)were shorter than those in the control group((109.61±14.84)h,(27.48±6.84)d),and the number of apnea ep-isodes in the combined group((4.08±1.19)times)was less than that in the control group((7.36±1.61)times)(t=13.206,9.157,20.981,all P<0.05).After treatment,the combined group showed a higher partial pressure of oxygen((74.29±6.64)mmHg(1 mmHg=0.133 kPa))compared to the control group((66.51±5.41)mmHg),and the partial pressure of carbon dioxide in the combined group((41.51±5.26)mmHg)was lower than that in the control group((45.06±6.04)mmHg)(t=11.633,5.676,both P<0.05).After treatment,the levels of creatine kinase-MB,malondialdehyde,and C-reactive protein in the combined group((34.91±6.49)U/L,(23.59±3.41)μmol/L,(58.49±4.64)μg/L,respectively)were all lower than those in the control group((45.45±7.31)U/L,(30.24±4.64)μmol/L,(73.41±5.30)μg/L,respectively)(t=13.808,14.789,27.125,all P<0.05).The incidence of complications was 4.27%(7/164)in the control group and 2.44%(4/164)in the combined group,with no statistically signif-icant difference between the two groups(χ2=0.376,P=0.540).Conclusion Caffeine citrate combined with INSURE can im-prove the efficacy in neonates with NRDS,shorten the duration of oxygen therapy and hospitalization,improve blood gas analy-sis parameters,and ameliorate markers of myocardial injury,oxidative stress and inflammation,with a favorable safety profile.
Keywords：caffeine citraterespiratory distress syndromemalondialdehydearterial partial pressure of oxygencre-atine kinase-MBC-reactive protein
Publication Date：2026-03-25
Online Publishing Date：2026-04-07(First online date of this platform, not the publication date of the document)
Pages：4( 325-328 )