Amplitude Integrated Electroencephalogram Study of the Effect of Caffeine Citrate on Brain Development in Low Weight Infants with Apnea

Abstract

Background: To investigate the effect of caffeine citrate on the integrated brain electroencephalogram (EEG) of apnea and low birth weight infants.
 Methods: Overall, 212 infants with apnea and low birth weight admitted to Xuzhou Central Hospital from June 2016 to June 2018 were enrolled. The infants were divided into control group and observation group according to the random number table method, 106 cases in each group. Infants in control group were treated with aminophylline, and infants in the observation group were given caffeine citrate. All children were continuously tested by digital amplitude integrated brain function monitor. The amplitude-integrated electroencephalogram (aEEG) was used to detect sleep arousal cycle (Cy), graphic continuity (Co), lower edge amplitude value (LB) scores, aEEG continuous voltage and periodic occurrence rate, narrowband voltage and bandwidth.
 Results: After treatment, scores of Cy, Co and LB increased in both groups, and the scores were significantly higher in observation group than in control group (P=0.029, 0.017, 0.047). After treatment, continuous voltage positive rate, sleep-wake cycle occurrence rate, and narrow-band lower boundary voltage increased in both groups, and the values were significantly higher in observation group than in control group (P=0.011, 0.042). After treatment, aEEG detection bandwidth and the upper boundary voltage of the narrow band decreased in both groups, and the values were significantly lower in observation group than in control group (P=0.007, 0.020, 0.032).
 Conclusion: Citrate caffeine can alleviate the brain development of low-weight infants with apnea, improve brain electrical activity and promote brain function and maturity.

The effect of acute respiratory events and respiratory stimulants on EEG-recorded brain activity in neonates: A systematic review

“…The methods for analysis are not clearly specified, such as how SATS were identified. Yang et al (2019) China, Western Pacific RCT. Low birth weight preterm infants enrolled in either the caffeine group (mean 32.56 ± 2.35 weeks GA) and the control group who received aminophylline (33.02 ± 1.98 weeks GA).…”

“…Four of 14 (28.6 %) of the included studies described the effect of respiratory stimulants (used for apnoea treatment or given prophylactically) on the EEG in a total of 315 infants ( Table 3 ) . Caffeine in varying doses was used in all four studies ( Table 3 ), and aminophylline use was reported in one study ( Yang et al, 2019 ). All four studies were of preterm infants, one was an RCT ( Yang et al, 2019 ) and three were cohort studies ( Dix et al, 2018 , Hassanein et al, 2015 , Supcun et al, 2010 ).…”

“…Caffeine in varying doses was used in all four studies ( Table 3 ), and aminophylline use was reported in one study ( Yang et al, 2019 ). All four studies were of preterm infants, one was an RCT ( Yang et al, 2019 ) and three were cohort studies ( Dix et al, 2018 , Hassanein et al, 2015 , Supcun et al, 2010 ).…”

“…None of the included studies found a significant difference in the apnoea rate or respiratory rate after stimulant introduction compared with before, however, in many cases the stimulant was given prophylactically. The aEEG features assessed included changes in continuity pattern, arousal from sleep ( Hassanein et al, 2015 , Yang et al, 2019 ), spontaneous activity transient (SAT) rate and interval, ( Dix et al, 2018 ), aEEG amplitude ( Dix et al, 2018 , Supcun et al, 2010 , Yang et al, 2019 ), voltage and bandwidth ( Yang et al, 2019 ). Importantly, no respiratory stimulant studies investigated how changes in EEG during apnoea were altered with stimulant use – they only investigated EEG changes in relation to the start of drug therapy.…”

“…Respiratory stimulant use significantly increased aEEG continuity ( Hassanein et al, 2015 , Supcun et al, 2010 , Yang et al, 2019 ), sleep arousal ( Hassanein et al, 2015 , Yang et al, 2019 ), SAT rate ( Dix et al, 2018 ), lower edge amplitude and boundary voltage values ( Yang et al, 2019 ). Dix et al (2018) , however, reported no changes in EEG amplitude after caffeine administration.…”