Regional cerebral blood flow velocity after aminophylline therapy in premature newborn infants

Ghai, Vivek; Raju, Tonse N.K.; Kim, Shin Y.; McCulloch, Kristine M.

doi:10.1016/s0022-3476(89)80155-6

Cited by 16 publications

(9 citation statements)

References 16 publications

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“…These results apparently differ from previously studies that found that aminophylline [4,[6][7][8][9] and theophylline [5] significantly reduce CBF [5,[7][8][9] and CBF velocity [4,6]. Nonetheless, the study design of these papers is very different from ours: (1) loading doses of aminophylline (or theophylline) were administered to the patients; (2) some studies evaluated CBF [5,[7][8][9] and others evaluated CBF velocity [4,6]; (3) some studies were performed by cerebral Doppler ultrasounds [4,6], others by xenon clearance technique [5,7], or by NIRS [8,9]; (4) none of them provided continuous monitoring of cerebral hemodynamics that was able to show transient and slight changes, and (5) there is wide variability in the study period. In particular, Bucher et al [9] applied NIRS from 10 min before to 20 min after administration of aminophylline, while in the remaining studies data collection started 60 min after drug administration or later, and none of them investigated possible changes during this initial unrecorded period.…”

Section: Discussioncontrasting

confidence: 99%

Brain Hemodynamic Changes in Preterm Infants after Maintenance Dose Caffeine and Aminophylline Treatment

et al. 2000

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Objective: To investigate the acute effects of low-dose caffeine and aminophylline on cerebral blood flow in preterm infants, using both near-infrared spectroscopy (NIRS) and cerebral Doppler ultrasonography. Methods: Preterm infants with a gestational age of <32 weeks and birth weight of <1,500 g were randomized to receive either caffeine or aminophylline treatment for apnea of prematurity. The study period went from 30 min before to 60 min after the administration of the maintenance dose of pure caffeine (2.5 mg/kg once a day) or aminophylline (1.25 mg/kg twice a day). NIRS was used to measure changes in oxygenated hemoglobin (O₂Hb), deoxygenated hemoglobin (HHb), oxidized-reduced cytochrome aa3 (CtOx), and mean cerebral oxygen saturation (SmO₂ = O₂Hb/total Hb). Changes in cerebral blood volume (ΔCBV) after caffeine or aminophylline administration were calculated. Cerebral blood flow velocity (CBV) in the pericallosal artery was evaluated by cerebral Doppler ultrasounds. Results: Data collected by NIRS and cerebral Doppler ultrasounds did not show significant differences before and after caffeine treatment. We observed a significant increase in O₂Hb and HHb concentration and in CBV at 30 min after the infusion of aminophylline, which tended to return to baseline at the end of the study period. Conclusion: Caffeine does not significantly affect brain hemodynamics, while aminophylline induces a significant transient increase in O₂Hb and HHb concentration and CBV.

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Section: Discussioncontrasting

confidence: 99%

Brain Hemodynamic Changes in Preterm Infants after Maintenance Dose Caffeine and Aminophylline Treatment

et al. 2000

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“…Rosenkrantz and Oh observed a 21% reduction of cerebral blood flow velocity after intravenous aminophylline, but this reduction may partly have been caused by the concomitant decrease of PaCO2 [14]. In other studies, the cerebral blood flow velocity seemed to be unaffected by aminophylline or caffeine [2,9,15,17]. The failure of demonstrating a reduction in CBF, however, may be because these investigators did not take the intra-individual changes in PaCO2 into account.…”

Section: Discussionmentioning

confidence: 92%

Aminophylline reduces cerebral blood flow in stable, preterm infants without affecting the visual evoked potential

Pryds

Schneider

1991

Eur J Pediatr

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The effect of intravenous aminophylline (10 mg/kg) on cerebral blood flow (CBF) and single flash visual evoked potential (VEP) was investigated in 16 preterm infants (range 25-34 weeks). All infants were weaned from mechanical ventilation and had normal brain ultrasonograms. CBF, PaO2, PaCO2, mean arterial blood pressure and VEP were recorded before, immediately after and 1 h after the administration of aminophylline. When intra-individual changes in PaCO2 were taken into account, mean CBF was 5.5% lower than the baseline value immediately after administration of aminophylline, but this was not statistically significant (P = 0.14). After 1 h, however, CBF had decreased by a mean of 13.8% (P = 0.0003). The cerebral function estimated from VEP was not influenced by aminophylline since the VEP configuration and the VEP parameters remained constant throughout the study. It is concluded that aminophylline reduces cerebral blood flow in stable, preterm infants and apparently without inducing adverse effects on cerebral function.

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“…Several studies have demonstrated an increase in heart rate of 8-20 bpm 1-48 h after a loading dose of 4-6 mg/kg body weight [12,21]. This increase is dose dependent [19].…”

Section: Discussionmentioning

confidence: 98%

Effect of aminophylline on cerebral haemodynamics and oxidative metabolism in premature infants

et al. 1994

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The effect of aminophylline on cerebral blood volume and oxidative metabolism in newborn infants was investigated with near infrared spectroscopy (NIRS). Thirteen mechanically ventilated premature infants who received aminophylline to facilitate weaning from the respirator were selected. Gestational age ranged between 26 and 34 weeks, postnatal age between 1 and 7 days and birth weight between 760 and 2300 g. A bolus of 6 mg aminophylline/kg body weight was infused within 2 min. NIRS was performed continuously across the head to monitor changes in cerebral blood volume and cytochrome c oxidase. Heart rate, transcutaneous carbon dioxide tension (tcpCO2) and arterial haemoglobin oxygen saturation (SO2) were recorded simultaneously. The infusion of aminophylline was associated with an increase in heart rate (median 12, interquartile range 5-20 beats per min, P = 0.0004) and a drop in tcpCO2 (median -0.4, interquartile range -0.1 to -0.5 kPa, P = 0.015). Oxygen saturation remained stable (+/- 3%). A decrease in cerebral blood volume was measured with NIRS in 9/13 patients (median -0.15 ml/100g brain tissue, interquartile range +0.08 to -0.28, P = 0.10). Oxidized cytochrome c oxidase decreased in 11/13 patients (median -0.27 mumol/l, interquartile range -0.19 to -0.44, P = 0.01). Our findings demonstrate an immediate step-response of heart rate and tcpCO2 to aminophylline in premature infants. The simultaneous reduction of cytochrome c oxidase in the brain cannot be explained as a consequence of changes in tcpCO2 or changes in cerebral blood volume. We therefore speculate that aminophylline interferes directly with cerebral metabolism.

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Regional cerebral blood flow velocity after aminophylline therapy in premature newborn infants

Cited by 16 publications

References 16 publications

Brain Hemodynamic Changes in Preterm Infants after Maintenance Dose Caffeine and Aminophylline Treatment

Brain Hemodynamic Changes in Preterm Infants after Maintenance Dose Caffeine and Aminophylline Treatment

Aminophylline reduces cerebral blood flow in stable, preterm infants without affecting the visual evoked potential

Effect of aminophylline on cerebral haemodynamics and oxidative metabolism in premature infants

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