Evidence-based methylxanthine use in the NICU.

The introduction of methylxanthines, especially caffeine, for the treatment of apnea of prematurity has been one of the most important and effective therapies in the neonatal intensive care unit (NICU) to date. Several trials have demonstrated its effectiveness in most NICU infants. It remains a cost-effective intervention with minimal short- and long-term risks when used appropriately. Caffeine also seems to be effective for reducing the risk of bronchopulmonary dysplasia and patent ductus arteriosus, and for decreasing the need for reintubation. For the infant with apnea, currently there does not seem to be any more effective treatment, and caffeine is also more effective and safer than any other methylxanthine.