<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec id="j_jccm-2023-0003_s_005"><h3>Introductions</h3>
<p>Caffeine is commonly used as a respiratory stimulant for the treatment of apnea of prematurity in neonates. However, there are no reports to date of caffeine used to improve respiratory drive in adult patients with acquired central hypoventilation syndrome (ACHS).</p></sec>
<sec id="j_jccm-2023-0003_s_006"><h3>Presentation of case series</h3>
<p>We report two cases of ACHS who were successfully liberated from mechanical ventilation after caffeine use, without side effects. The first case was a 41-year-old ethnic Chinese male, diagnosed with high-grade astrocytoma in the right hemi-pons, intubated and admitted to the intensive care unit (ICU) in view of central hypercapnia with intermittent apneic episodes. Oral caffeine citrate (1600mg loading followed by 800mg once daily) was initiated. His ventilator support was weaned successfully after 12 days. The second case was a 65-year-old ethnic Indian female, diagnosed with posterior circulation stroke. She underwent posterior fossa decompressive craniectomy and insertion of an extra-ventricular drain. Post-operatively, she was admitted to the ICU and absence of spontaneous breath was observed for 24 hours. Oral caffeine citrate (300mg twice daily) was initiated and she regained spontaneous breath after 2 days of treatment. She was extubated and discharged from the ICU.</p></sec>
<sec id="j_jccm-2023-0003_s_007"><h3>Conclusion</h3>
<p>Oral caffeine was an effective respiratory stimulant in the above patients with ACHS. Larger randomized controlled studies are needed to determine its efficacy in the treatment of ACHS in adult patients.</p></sec>
</abstract>

Introductions
Caffeine is commonly used as a respiratory stimulant for the treatment of apnea of prematurity in neonates. However, there are no reports to date of caffeine used to improve respiratory drive in adult patients with acquired central hypoventilation syndrome (ACHS).
Presentation of case series
We report two cases of ACHS who were successfully liberated from mechanical ventilation after caffeine use, without side effects. The first case was a 41-year-old ethnic Chinese male, diagnosed with high-grade astrocytoma in the right hemi-pons, intubated and admitted to the intensive care unit (ICU) in view of central hypercapnia with intermittent apneic episodes. Oral caffeine citrate (1600mg loading followed by 800mg once daily) was initiated. His ventilator support was weaned successfully after 12 days. The second case was a 65-year-old ethnic Indian female, diagnosed with posterior circulation stroke. She underwent posterior fossa decompressive craniectomy and insertion of an extra-ventricular drain. Post-operatively, she was admitted to the ICU and absence of spontaneous breath was observed for 24 hours. Oral caffeine citrate (300mg twice daily) was initiated and she regained spontaneous breath after 2 days of treatment. She was extubated and discharged from the ICU.
Conclusion
Oral caffeine was an effective respiratory stimulant in the above patients with ACHS. Larger randomized controlled studies are needed to determine its efficacy in the treatment of ACHS in adult patients.

The Use of Caffeine Citrate for Respiratory Stimulation in Acquired Central Hypoventilation Syndrome: A Case Series

The Journal of Critical Care Medicine

This work is licensed under the Creative Commons Attribution 4.0 International License.

Introductions
Caffeine is commonly used as a respiratory stimulant for the treatment of apnea of prematurity in neonates. However, there are no reports to date...

The Use of Caffeine Citrate for Respiratory Stimulation in Acquired Central Hypoventilation Syndrome: A Case Series

Article Category: Case Report

Published Online: Feb 08, 2023

Page range: 49 - 54

Received: Jul 14, 2022

Accepted: Dec 27, 2022

DOI: https://doi.org/10.2478/jccm-2023-0003

Keywords
caffeine, respiratory stimulation, acquired central hypoventilation, apnea

© 2023 Pei Ling Tan, Chuan Poh Lim, Sharon Ong, Geoffrey Sithamparapillai Samuel, published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

The Use of Caffeine Citrate for Respiratory Stimulation in Acquired Central Hypoventilation Syndrome: A Case Series

Article Category: Case Report

Published Online: Feb 08, 2023

Page range: 49 - 54

Received: Jul 14, 2022

Accepted: Dec 27, 2022

DOI: https://doi.org/10.2478/jccm-2023-0003

Keywordscaffeine, respiratory stimulation, acquired central hypoventilation, apnea

© 2023 Pei Ling Tan, Chuan Poh Lim, Sharon Ong, Geoffrey Sithamparapillai Samuel, published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Keywords
caffeine, respiratory stimulation, acquired central hypoventilation, apnea