Caffeine Impairs Cerebral and Intestinal Blood Flow Velocity in Preterm Infants

Hoecker, Christina; Nelle, Mathias; Poeschl, Johannes; Beedgen, B.; Linderkamp, Otwin

doi:10.1542/peds.109.5.784

Cited by 109 publications

(106 citation statements)

References 25 publications

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“…Hoecker et al 4,6 examined the effect of caffeine loading in two regimens in two groups of 16 infants and showed no change in left ventricular CO (LVCO), HR or BP when measured 1 and 2 h after in one regimen and 1, 2 and 20 h later in the second regimen. Walther et al 5 showed an increase in LVCO and HR in 11 infants treated with aminophylline, however postaminophylline determinations were made 4 h after maintenance dose.…”

Section: Discussionmentioning

confidence: 99%

Acute hemodynamic effects of caffeine administration in premature infants

et al. 2008

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Objective: Administration of caffeine citrate (caffeine) has been a central component of the treatment of apnea of prematurity. However, given its multiple pharmacologic effects, caffeine might be expected to produce hemodynamic changes in heart rate, stroke volume, cardiac output and vascular resistance.Study Design: In this prospective observational study, we report the hemodynamic effects of intravenous caffeine administration in a population of premature infants who received caffeine to correct or prevent apnea of prematurity.Methods: Hemodynamic effects of caffeine were determined in 31 infants. Stroke volume was measured via echocardiogram, using velocity time integral at the aortic root diameter. Statistically univariate analyses were performed parametrically using paired t-test and nonparametrically (sign test). Multivariate linear regression models were used to identify subgroup covariate effects.Results: After intravenous caffeine, cardiac index increased in 31 of 31 trials, by an average of 14.6 ± 16.3% (s.d.); stroke volume increased in 24 of 31 trials, by 7.8±12.2%; heart rate increased in 28 of 31 trials by 7.7 ± 7.2 beats per min; and blood pressure increased in 25 of 31 trials, by 4.1±5.8 mm Hg (all P<0.001). Multivariate linear regression revealed no significant effect of dose, birth weight, gestational age or postnatal age.Conclusions: Intravenous caffeine consistently increases cardiac output and blood pressure in relatively stable premature infants, when given to treat or prevent apnea of prematurity. We speculate that there may be a role for caffeine in the hemodynamic treatment of hypotensive/ hypoperfused infants.

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Section: Discussionmentioning

confidence: 99%

Acute hemodynamic effects of caffeine administration in premature infants

et al. 2008

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“…NIRS and cranial ultrasound studies were performed within 24 h of birth and repeated at 48 and 72 h of life. NIRS and cerebral ultrasound were not performed within 2 h of clinical interventions that are known to alter cerebral oxygen supply and extraction, including administration of surfactant (36), indomethacin/ibuprofen (37), and caffeine (38).…”

Section: Cerebral Oxygen Delivery and Consumptionmentioning

confidence: 99%

Effects of antenatal magnesium sulfate treatment for neonatal neuro-protection on cerebral oxygen kinetics

2015

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“…[76][77][78] As a result of these findings there were concerns about the long-term effects of caffeine on brain development. However, results of placebo-controlled multicenter trials showed that caffeine therapy for AOP reduces the incidence of bronchopulmonary dysplasia 79 and improves survival without neurodevelopmental disability in very low birth weight infants.…”

Section: Treatment Strategiesmentioning

confidence: 99%

Apnea of prematurity: pathogenesis and management strategies

Mathew

2010

J Perinatol

105

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Apnea of prematurity (AOP) is a significant clinical problem manifested by an unstable respiratory rhythm reflecting the immaturity of respiratory control systems. This review will address the pathogenesis of and treatment strategies for AOP. Although the neuronal mechanisms leading to apnea are still not well understood, recent decades have provided better insight into the generation of the respiratory rhythm and its modulation in the neonate. Ventilatory responses to hypoxia and hypercarbia are impaired and inhibitory reflexes are exaggerated in the neonate. These unique vulnerabilities predispose the neonate to the development of apnea. Treatment strategies attempt to stabilize the respiratory rhythm. Caffeine remains the primary pharmacological treatment modality and is presumed to work through blockade of adenosine receptors A 1 and A 2 . Recent evidences suggest that A 2A receptors may have a greater role than previously thought. AOP typically resolves with maturation suggesting increased myelination of the brainstem.

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Caffeine Impairs Cerebral and Intestinal Blood Flow Velocity in Preterm Infants

Abstract: Oral administration of a high loading dose of caffeine results in marked reduction of cerebral and intestinal BFV, without changing LVO, blood pressure, and heart rate.

Cited by 109 publications

References 25 publications

Acute hemodynamic effects of caffeine administration in premature infants

Acute hemodynamic effects of caffeine administration in premature infants

Effects of antenatal magnesium sulfate treatment for neonatal neuro-protection on cerebral oxygen kinetics

Apnea of prematurity: pathogenesis and management strategies

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