A 2 week old infant, born at 36 weeks gestation was admitted to the paediatric ward in November with a 24 hour history of runny nose, cough, and episodes of shallow breathing and apnoeas. This was thought to be due to bronchiolitis, and the consultant paediatrician suggested starting the baby on caffeine (theophylline derivative with less side effects). As the resident middle grade doctor, I knew that caffeine has been used widely in neonatal units for apnoea of prematurity, but I wondered if there was any evidence for its use in this clinical situation.

Structured clinical question

In infants with bronchiolitis [patient] does caffeine [intervention] reduce or prevent apnoeas [outcome]?

Search strategy and outcome

Cochrane database of systematic reviews: No directly relevant study found, but there was one …