Efficacy of caffeine in treatment of apnea in the low-birth-weight infant

Aranda, Jacob V.; Gorman, Winifred; Bergsteinsson, Hardur; Gunn, Tania R.

doi:10.1016/s0022-3476(77)80718-x

Cited by 243 publications

(99 citation statements)

References 20 publications

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“…2 Umbilical cord caffeine levels detected in our study were low; hence, there was no decrease in the occurrence of apnea because our detectable levels were below therapeutic levels. One limitation of this study is the lack of comparison in the number of apnea spells between both groups.…”

Section: Mcculloch Et Al Quantified Caffeine In Umbilical Bloodcontrasting

confidence: 47%

“…1,2 Adequate treatment of apnea in the neonatal period is of great importance, as a higher incidence of periintraventricular hemorrhage (PIVH), hydrocephaly, periventricular leukomalacia (PVL), need for ventilatory support for longer time and alterations in neurological development are observed in the first year of life when preterm infants with apnea are compared to those without apnea. 3 The role of maternal consumption of caffeine and occurrence of apnea in preterm neonates have aroused general interest.…”

Section: Introductionmentioning

confidence: 99%

“…3 The role of maternal consumption of caffeine and occurrence of apnea in preterm neonates have aroused general interest. As caffeine is a substance that crosses the Serum levels of caffeine in umbilical cord and apnea of prematurity Cláudia Regina Hentges, 1 Renata Rostirola Guedes, 1 Rita C. Silveira, 2 Renato S. Procianoy 2 placental barrier, it could have an intrauterine stimulation of the fetus's respiratory center. [4][5][6] Caffeine is probably the most frequently drug taken in the world, consumed by people of all ages.…”

Section: Introductionmentioning

confidence: 99%

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Níveis plasmáticos de cafeína no cordão umbilical e apneia da prematuridade

Hentges¹,

Guedes²,

Silveira³

et al. 2010

J. Pediatr. (Rio J.)

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Objective: To determine the influence of presence of caffeine in umbilical cord blood on apnea occurrence. Methods:A prospective cohort study with preterm newborns with birth weight lower than 2,000 g was undertaken. Exclusion criteria were: mothers who received opioids; mechanical ventilation during the first 4 days of life; cerebral and major cardiac malformations; perinatal asphyxia; severe periintraventricular hemorrhage; exchange transfusion before the fourth day of life; and those who received methylxantine prior to extubation. Neonates were divided into detectable and undetectable caffeine in umbilical cord blood. Newborns were followed for the first 4 days for occurrence of apnea spells.Results: Eighty-seven newborns with and 40 without detectable caffeine in umbilical cord blood were studied. Median caffeine concentration of the 87 patients with detectable caffeine in umbilical blood was 2.3 µg/mL (0.2-9.4 µg/mL). There was no association between occurrence of apnea spells and presence of caffeine in umbilical cord blood. Neonates with detectable caffeine in umbilical blood had borderline later apnea (66.3±4.14 hours) than those with undetectable levels (54.2±6.26 hours). Conclusion:Detected levels of caffeine in umbilical cord blood did not decrease occurrence of apnea of prematurity, but it had a borderline effect delaying its occurrence, suggesting that even a low level of caffeine in umbilical cord blood might delay occurrence of apnea spells.J Pediatr (Rio J). 2010;86(2):137-142: Prematurity, apnea, caffeine, low-birth-weight infant.

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Section: Mcculloch Et Al Quantified Caffeine In Umbilical Bloodcontrasting

confidence: 47%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Níveis plasmáticos de cafeína no cordão umbilical e apneia da prematuridade

Hentges¹,

Guedes²,

Silveira³

et al. 2010

J. Pediatr. (Rio J.)

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“…The beneficial effects of caffeine in these contexts are widely documented in both randomized and observational trials. [1][2][3] However, caffeine has other physiologic effects, including stimulating the central nervous and cardiovascular system, 4 enhancing catecholamine secretion, 4 and increasing basal metabolic rate. 4 At the pharmacologic level, caffeine acts by blocking adenosine receptors A1 and A2a, increasing cyclic 3, 5 adenosine monophosphate by inhibiting phosphodiesterase, and translocating intracellular calcium.…”

Section: Introductionmentioning

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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“…In particular, they can suddenly stop breathing (apnea) spontaneously and quite frequently [4] . To reduce the occurrence of apneas, a caffeine treatment is often administered to premature neonates [5][6][7] . This treatment may last several weeks and can induce various secondary effects (on ventilation, sleep, metabolism, weight, glomerular filtration, etc.)…”

Section: Introductionmentioning

confidence: 99%