Objective To analyze the efficacy of different doses of caffeine combined with nasal intermittent positive pressure ventilation (NIPPV) in the treatment of premature infants with apnea.

Methods A total of 72 premature infants with apnea from May 2020 to October 2022 were randomly divided into observation group (treated with 10 mg/kg caffeine and NIPPV) and control group (treated with 5 mg/kg caffeine and NIPPV), with 36 cases in each group. The total effective rate, hospital stay, usage time of NIPPV, the number of apnea, arterial partial pressure of oxygenp_a(O₂), arterial partial pressure of carbon dioxidep_a(CO₂), adverse reactions and clinical outcomes were compared between two groups.

Results The total effective rate of the observation group was significantly higher than that of the control group, while the hospital stay, usage time of NIPPV and the number of apnea were significantly lower or shorter than those of the control group (P < 0.05). Repeated measurement analysis of variance showed that there were significant differences in the time, between-group and time-group interaction effects for p_a(O₂) and p_a(CO₂) (P < 0.05); after 24 and 72 hours of treatment, the p_a(O₂) in the observation group was significantly higher, while the p_a(CO₂) was significantly lower than that in the control group (P < 0.05). There were no significant differences in the incidence of adverse reactions, bronchopulmonary dysplasia, retinopathy of prematurity, necrotizing enterocolitis, intraventricular hemorrhage, periventricular leukomalacia and mortality rate between the observation group and the control group (P>0.05).

Conclusion Application of 10 mg/kg caffeine combined with NIPPV has a relatively ideal effect in the treatment for premature infants with apnea, which is beneficial for improving blood oxygen and shortening the usage time of NIPPV Moreover, it has good clinical outcomes without serious adverse reactions or complications