Caffeine intoxication in a premature neonate

Ergenekon, Ebru; Dalgıç, Nazan; Aksoy, Erhan; Koç, Esin; Atalay, Yıldız

doi:10.1046/j.1460-9592.2001.00753.x

Cited by 28 publications

(14 citation statements)

References 7 publications

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“…Case reports of accidental caffeine overdose in premature infants have described a variety of acute neurologic, cardiovascular, and metabolic abnormalities. 80 One case report described a 28-week infant who developed rhabdomyolysis while receiving standard caffeine dosing, with a caffeine level of 32.59 µg/ml. 81 Other studies, however, have reported caffeine levels of 30-40 µg/ml without significant side effects.…”

Section: Mechanisms Of Actionmentioning

confidence: 99%

Caffeine: an evidence-based success story in VLBW pharmacotherapy

Dobson

Hunt

2018

Pediatr Res

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Apnea of prematurity (AOP) is a common and pervasive problem in very low birth weight infants. Methylxanthines were reported >40 years ago to be an effective therapy and, by the early 2000s, caffeine had become the preferred methylxanthine because of its wide therapeutic index, excellent bioavailability, and longer half-life. A clinical trial to address unresolved questions and toxicity concerns, completed in 2004, confirmed significant benefits of caffeine therapy, including shorter duration of intubation and respiratory support, reduced incidence of chronic lung disease, decreased need for treatment of patent ductus arteriosus, reduced severity of retinopathy of prematurity, and improved motor and visual function. Cohort studies have now further delineated the benefits of initiation of therapy before 3 days postnatal age, and of higher maintenance doses to achieve incremental beneficial effects. This review summarizes the pivotal and in particular the most recent studies that have established the safety and efficacy of caffeine therapy for AOP and other respiratory and neurodevelopmental outcomes. Caffeine has a very favorable benefit-to-risk ratio, and has become one of the most prescribed and cost-effective pharmacotherapies in the NICU.

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Section: Mechanisms Of Actionmentioning

confidence: 99%

Caffeine: an evidence-based success story in VLBW pharmacotherapy

Dobson

Hunt

2018

Pediatr Res

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“…In addition to treating AOP, it has been shown that caffeine reduces bronchopulmonary dysplasia, failure to extubate, and the time on mechanical ventilators [5,6]. However, caffeine was also shown to impair cerebral and intestinal blood flow velocity [7], and if it is administered improperly, such as overdosing, it might have detrimental effects on preterm infants [8,9]. Furthermore, Carnielli et al [10] showed that caffeine treatment increases energy expenditure and suggested that it might retard infant growth.…”

Section: Introductionmentioning

confidence: 99%

The effect of mechanical or electrical stimulation on apnea length in mice

et al. 2018

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Premature birth is a leading cause of infant mortality which is often attributed to irregular breathing and apnea of prematurity. A common treatment for apnea is caffeine to stimulate the brain's respiratory center. However, caffeine's long term effect on infant development is not fully comprehended. We hypothesized that noninvasive localized body stimulation regularizes breathing pattern. We investigated the impact of electrical or mechanical stimulation on breathing in mice. After the mice were ventilated for 28 s to induce apnea, mice were taken off the ventilator while receiving mechanical, electrical, or no stimulation in a randomized order. Both stimuli targeted the diaphragm area through a custom-built belt with vibrating motors or adhesive electrodes. After each apnea cycle, the time to take the first breath (T) was recorded. The electrical stimulation given at 4.5, 8.3, 16.7 V (pulse rate = 3 Hz, pulse width = 120 ls) showed no reduction in T. Electrical stimulation at pulse rates of 10 or 20 Hz (16.7 V, pulse width 260 ls) showed a detrimental effect increasing T by * 7% compared to control values (p = 0.005, p = 0.038 respectively). High and medium intensity mechanical stimulations significantly reduced T by 11.74 (p \ 10-13) and by 17.08% (p \ 10-8), respectively. Further reducing the amplitude of vibrations did not affect T. When the probe was attached to the ankles, only the high intensity vibrations resulted in a decrease in T (p \ 10-13). Mechanical vibrations, applied at various intensities and locations, could be used to treat irregular breathing and apnea in infants.

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“…However, caffeine therapy is associated with variable side effects including tachycardia, jitteriness, and feeding intolerance in preterm infants [7]. Caffeine was also found to increase oxygen consumption and transient decrease in the rate of growth of preterm, very low birth weight, infants [2].…”

Section: Introductionmentioning

confidence: 99%

High versus low-dose caffeine for apnea of prematurity: a randomized controlled trial

et al. 2015

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• Caffeine therapy for treatment of apnea of prematurity has been well established over the past few years. The optimal loading and maintenance dose of caffeine in preterm infants is not well-studied. What is New: • This double blind randomized controlled trial demonstrated that using a higher, than current standard, loading and maintenance doses of caffeine for treatment of apnea in preterm infants is well tolerated and significantly decrease the frequency of apnea.

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Caffeine intoxication in a premature neonate

Cited by 28 publications

References 7 publications

Caffeine: an evidence-based success story in VLBW pharmacotherapy

Caffeine: an evidence-based success story in VLBW pharmacotherapy

The effect of mechanical or electrical stimulation on apnea length in mice

High versus low-dose caffeine for apnea of prematurity: a randomized controlled trial

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