Effects of Caffeine on Intermittent Hypoxia in Infants Born Prematurely

Rhein, Lawrence; Dobson, Nicole R.; Darnall, Robert A.; Corwin, Michael J.; Heeren, Timothy; Poets, Christian F.; McEntire, Betty L.; Hunt, Carl E.; Bada, Henrietta S.; Carlo, Wally; Consenstein, Larry; Gregory, Mary L.; Hendricks‐Muñoz, Karen D.; Hoy, Deborah; Karamchandani, Nilima; Klarr, Judith; Prabhash, Kumar; Leach, Corinne L.; Richardson, Joan; Rosenkrantz, Ted S.; White, Robert D.

doi:10.1001/jamapediatrics.2013.4371

Cited by 145 publications

(93 citation statements)

References 39 publications

(22 reference statements)

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“…A recent study in preterm infants who had been treated with caffeine for apnea showed a decrease in the frequency of intermittent hypoxia episodes in those who received a prolonged course of therapy compared with a usual-care group. 12 Further study is necessary to determine the implications of this finding.…”

Section: Monitoring For Apnea/ Bradycardiamentioning

confidence: 97%

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Apnea of Prematurity

2016

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Apnea of prematurity is one of the most common diagnoses in the NICU. Despite the frequency of apnea of prematurity, it is unknown whether recurrent apnea, bradycardia, and hypoxemia in preterm infants are harmful. Research into the development of respiratory control in immature animals and preterm infants has facilitated our understanding of the pathogenesis and treatment of apnea of prematurity. However, the lack of consistent defi nitions, monitoring practices, and consensus about clinical signifi cance leads to signifi cant variation in practice. The purpose of this clinical report is to review the evidence basis for the defi nition, epidemiology, and treatment of apnea of prematurity as well as discharge recommendations for preterm infants diagnosed with recurrent apneic events.

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Section: Monitoring For Apnea/ Bradycardiamentioning

confidence: 97%

“…In a recent study in former preterm infants after discontinuation of medical therapy for apnea, the mean number of seconds/hour of oxygen saturation less than 80% was 20.3 at 35 weeks' PMA, decreasing to 6.8 seconds/hour at 40 weeks' PMA. 12 …”

Section: Epidemiology and Time Course To Resolutionmentioning

confidence: 99%

Apnea of Prematurity

2016

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“…Intermittent hypoxia events were also decreased in infants for whom caffeine treatment was extended. 60 Some studies have reported a reduction in cerebral and intestinal blood flow in the first 2 hours after administration of caffeine, risk factors for the development of cerebral hemorrhage and necrotizing enterocolitis. 61 However, the trial by Schmidt et al showed no significant differences in rates of necrotizing enterocolitis and brain injuries between infants treated with caffeine and infants who received placebo.…”

Section: Unresolved Issues With Caffeinementioning

confidence: 99%

Apnea of prematurity: challenges and solutions

Picone¹,

Aufieri²,

Paolillo³

2014

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Apnea of prematurity is a developmental disorder that frequently affects preterm infants, especially those with lower gestational age. Even if apnea of prematurity is by definition a self-limiting condition, it can cause serious problems during the hospital stay and can potentially have long-term neurological and cognitive consequences depending on the severity and intensity of the episodes. The diagnosis of apnea of prematurity can be made only after excluding a number of diseases of the preterm infant in which apnea may be an epiphenomenon. Etiological diagnosis is essential for selection of appropriate treatment, which may be nonpharmacological or involve use of drugs.

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“…3,4 The potential neurodevelopmental impact of these often severe hypoxia events in the preterm infant is unknown. In one study, a greater frequency of IH in extremely low birth weight infants was associated with worse severity of retinopathy of prematurity.…”

mentioning

confidence: 99%

“…We may finally have an answer to the question of blood transfusions and reduction in apnea and IH in convalescent premature infants-it works, but the duration of the benefit remains unclear as studies have not examined the effect beyond 72 h. More importantly, does it matter? That conclusion awaits further understanding of the shortand long-term impact of IH on neurodevelopmental and other outcomes in preterm infants, and whether therapy for IH (with prolonged caffeine 4 or maintenance of higher hemoglobin thresholds) affects those outcomes. Until we have more data, Abu Jawdeh's study suggests that judicious use of red cell transfusions in premature infants 41 week of age with severe apnea or IH events may be properly considered as short-term management.…”

mentioning

confidence: 99%