Effect of caffeine on superior mesenteric artery blood flow velocities in preterm neonates

Wahed, Mohamed Abdel; Issa, Hanan M.; Khafagy, Soha M.; Raouf, Shaimaa M. Abdel

doi:10.1080/14767058.2017.1378337

Cited by 15 publications

(17 citation statements)

References 23 publications

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“…Although the United States Food and Drug Administration approved caffeine for apnea of prematurity, it also provided a warning that there may be a potential relationship between methyl xanthines and the development of NEC. Abdel et al found a significant decrease in the PSV and EDV and an increase in the RI of SMA blood flow after a loading dose of caffeine. These results suggested that high‐resistance intestinal blood flow may play a role in the pathogenesis of NEC …”

Section: Discussionmentioning

confidence: 98%

Early Doppler Ultrasound in the Superior Mesenteric Artery and the Prediction of Necrotizing Enterocolitis in Preterm Neonates

Yue

Deng

Yang

et al. 2019

J of Ultrasound Medicine

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Objectives-The purpose of this study was to reveal the correlation between superior mesenteric artery (SMA) blood flow in the first 12 hours of life and the risk of necrotizing enterocolitis (NEC) in preterm neonates.Methods-We conducted a prospective study. There were 104 preterm neonates included in our study. The SMA blood flow of each neonate was measured during the first 12 hours of life if the hemodynamic situation was stable. The results of Doppler ultrasound were confidential to the neonatologists and nurses. All of the demographics, comorbidities, and outcomes were recorded and analyzed.Results-Among all of the demographics and comorbidities, the gestational age was related to the measurements of SMA blood flow. We conducted a singlefactor analysis of the occurrence of NEC, including the peak systolic velocity (PSV), end-diastolic velocity, time-averaged mean velocity, differential velocity (DV), resistive index, and pulsatility index. A higher PSV (median [interquartile range], 54.165 [42.423-68.463] versus 42.195 [34.278-48.553] cm/s; P = .027) and DV (median [interquartile range], 47.445 [35.010-60.043] versus 32. 565 [27.545-39.073] cm/s; P = .020) were significantly related to the risk of NEC. In the logistic analysis including gestational age, PSV, and DV, NEC was significantly associated with gestational age (odds ratio [95% confidence interval], 0.644 [0.456-0.908]; P = .012) and DV (odds ratio [95% confidence interval], 1.144 [1.058-1.237]; P < .01). The area under the receiver operating characteristic curve for the DV was 0.768, with sensitivity 0.875 and specificity 0.604. The cutoff value of the DV was 34.835 cm/s. Conclusions-From this single-center study, we can see the promising value of Doppler ultrasound for the prediction of NEC, but further research is needed.

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Section: Discussionmentioning

confidence: 98%

Early Doppler Ultrasound in the Superior Mesenteric Artery and the Prediction of Necrotizing Enterocolitis in Preterm Neonates

Yue

Deng

Yang

et al. 2019

J of Ultrasound Medicine

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“…Soraisham et al [26] showed that a single 10 mg/kg intravenous loading dose of caffeine in preterm neonates (≤ 32 weeks' gestation) was not significantly reduced BFV in SMA. The last published study reported by Abdel Wahed et al [6] was investigated the effects of intravenous infusion of caffeine citrate at a loading dose of 20 mg/kg followed by a maintenance dose of 5-10 mg/kg/day on the SMA BFV in preterm infants (28-33 +6 weeks' gestation). The authors showed that blood flow in SMA was significantly reduced after caffeine infusion at a loading dose of 20 mg/kg, and that this effect was continued for at least two hours and improved after six hours [6].…”

Section: Discussionmentioning

confidence: 99%

“…The last published study reported by Abdel Wahed et al [6] was investigated the effects of intravenous infusion of caffeine citrate at a loading dose of 20 mg/kg followed by a maintenance dose of 5-10 mg/kg/day on the SMA BFV in preterm infants (28-33 +6 weeks' gestation). The authors showed that blood flow in SMA was significantly reduced after caffeine infusion at a loading dose of 20 mg/kg, and that this effect was continued for at least two hours and improved after six hours [6]. Soraisham et al [26] and Abdel Wahed et al [6] suggested that the effect of caffeine on intestinal blood flow might be dose-dependent.…”

Section: Discussionmentioning

confidence: 99%

“…Caffeine therapy is recommended to use for all premature neonates with high risk of needing mechanical ventilation at a loading dose of 20 mg/kg, followed by a maintenance dose of 5-10 mg/kg daily [4]. Although, the meta-analysis reported by Park et al [3] suggested that early caffeine usage in very low birth weight (VLBW) infants did not increased the risk of necrotizing enterocolitis (NEC), recently published studies showed that there was a potential association between caffeine usage and the development of NEC in premature infants [5,6]. Moreover, a recent experimental study showed that caffeine administration to newborn rats impaired lower esophageal sphincter (LES) and gastrointestinal motor function [7].…”

Section: Introductionmentioning

confidence: 99%

“…There is controversy and limited information about the usage of caffeine and its impact on the development of NEC [3,5,6]. We aimed to investigate the effects of subcutaneously caffeine citrate at loading dose of 20 mg/kg followed by a maintenance dose of 5 mg/kg on H/R-induced intestinal injury in newborn rats.…”

Section: Introductionmentioning

confidence: 99%

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Kafein sıçan yavrularında bağırsak hasarı gelişiminde predispozan bir risk faktörü mü?

Özdemir¹,

Saldıray²,

Enli³

et al. 2021

Pamukkale Medical Journal

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To investigate of histopathologic and biochemical effects of caffeine citrate in newborn rats with hypoxia/reoxygenation (H/R)-induced intestinal injury. Materials and methods: One-day-old, 32 Wistar albino newborn rats (n=8) were randomly divided into four groups: control group (group1, n=8), caffeine group (group2, caffeine citrate administered subcutaneously, n=8), H/R group (group3, exposed to H/R, n=8), and caffeine + H/R group (group4, caffeine citrate administered and exposed to H/R, n=8). Caffeine citrate was initiated at a loading dose of 20 mg/kg, followed by a maintenance dose of 5 mg/kg/day, subcutaneously. On day 4 th , all animals except for groups 1 and 2 were exposed to H/R and sacrificed 6 hours after H/R procedure. Histopathological injury scores (HISs), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and oxidative stress index (OSI: total oxidant status "TOS"/total antioxidant status "TAS") levels were measured in intestinal samples. Results: As histopathological, the most severe damage was observed in H/R-induced groups (p<0.01). Although not statistically significant, the mean HISs of caffeine group was higher than the control group and lower than the H/R group. The levels of TNF-α, IL-6 and OSI in the groups 2, 3 and 4 were significantly higher than the control group (p<0.05). However, these biochemical parameters in the caffeine group were significantly lower than those of the H/R-induced groups (p<0.01). Conclusion: This study showed that caffeine citrate significantly increased the intestinal tissue levels of TNF-α, IL-6, and OSI. As a result, caffeine may be a predisposing risk factor for developing intestinal injury.

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A systematic review and meta-analysis of the role of Doppler ultrasonography of the superior mesenteric artery in detecting neonates at risk of necrotizing enterocolitis

et al. 2023

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The role of postnatal Doppler measurements of the superior mesenteric artery (SMA) in detecting neonates at risk of necrotizing enterocolitis (NEC) remains uncertain; therefore, we systematically reviewed and meta-analyzed the existing evidence regarding the usefulness of SMA Doppler measurements in detecting neonates at risk for NEC. We used the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, and we included studies which reported the following Doppler ultrasonography indices: peak systolic velocity, end-diastolic velocity, time average mean velocity, differential velocity, pulsatility index (PI) and resistive index. Eight studies were eligible for inclusion in the meta-analysis. Evidence suggested that, during the first postnatal day, neonates who developed NEC had a significantly higher peak systolic velocity (mean difference of 2.65 cm/s (95% confidence interval [CI] 1.23, 4.06, overall effect Z=3.66, P<0.001)), higher PI (mean difference of 1.52 (95% CI 0.00, 3.04, Z=1.96, P=0.05)) and higher resistive index (mean difference of 1.09 (95% CI 0.59, 1.60, Z=4.24, P<0.001)), compared to neonates who did not develop NEC. However, our findings do not support a strong association between the Doppler ultrasound indices and development of NEC at the time of disease onset. This meta-analysis suggests that first postnatal day SMA Doppler parameters, namely peak systolic velocity, PI and resistive index, are higher in neonates who develop NEC. On the other hand, the aforementioned indices are of uncertain significance once the diagnosis of NEC has been established. Graphical abstract

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Effect of caffeine on superior mesenteric artery blood flow velocities in preterm neonates

Abstract: Blood flow in SMA is significantly reduced after caffeine citrate infusion at a loading dose of 20 mg/kg. This effect continues for at least 2 h. Meanwhile, SMA BFV seems not affected by maintenance doses.

Cited by 15 publications

References 23 publications

Early Doppler Ultrasound in the Superior Mesenteric Artery and the Prediction of Necrotizing Enterocolitis in Preterm Neonates

Early Doppler Ultrasound in the Superior Mesenteric Artery and the Prediction of Necrotizing Enterocolitis in Preterm Neonates

Kafein sıçan yavrularında bağırsak hasarı gelişiminde predispozan bir risk faktörü mü?

A systematic review and meta-analysis of the role of Doppler ultrasonography of the superior mesenteric artery in detecting neonates at risk of necrotizing enterocolitis

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