The effect of caffeine citrate on neural breathing pattern in preterm infants

Caffeine citrate is widely used to prevent and treat prematurity-associated apnea. The aim of this study was to characterize the effect of caffeine citrate on the neural control of breathing, especially central apnea, in premature infants. Preterm infants were evaluated for 30min before and 30min af...

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Vydané v:Early human development Ročník 91; číslo 10; s. 565 - 568
Hlavní autori: Parikka, Vilhelmiina, Beck, Jennifer, Zhai, Qian, Leppäsalo, Juha, Lehtonen, Liisa, Soukka, Hanna
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: Ireland Elsevier Ireland Ltd 01.10.2015
Predmet:
Advanced Basic Science
Apnea
Apnea - drug therapy
Caffeine - pharmacology
Caffeine - therapeutic use
Central Nervous System Stimulants - pharmacology
Central Nervous System Stimulants - therapeutic use
Citrates - pharmacology
Citrates - therapeutic use
Diaphragm electrical activity
Female
Humans
Infant, Newborn
Infant, Premature
Male
NAVA
Neonatal and Perinatal Medicine
Neurally adjusted ventilation
Respiration - drug effects
NAVA
Neurally adjusted ventilation
Apnea
Edi
Diaphragm electrical activity
neurally adjusted ventilatory assist
the electrical activity of the diaphragm
ISSN:0378-3782, 1872-6232, 1872-6232
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Shrnutí:Caffeine citrate is widely used to prevent and treat prematurity-associated apnea. The aim of this study was to characterize the effect of caffeine citrate on the neural control of breathing, especially central apnea, in premature infants. Preterm infants were evaluated for 30min before and 30min after caffeine citrate loading (20mg/kg). A feeding tube including miniaturized sensors was used to measure the diaphragm electrical activity (Edi) waveform. Central apnea was defined as any period where the Edi waveform was flat for >5s. Seventeen preterm infants with a mean age of three days and mean birth weight of 900 grams were evaluated. In addition to central apnea, several parameters including neural inspiratory time, neural respiratory rate, peak Edi, delta inspiratory change in Edi (phasic Edi) and minimum Edi on exhalation were measured. The majority of the apnea were short (5 to 10s) and the number of apnea correlated with birth weight (p=0.039). Caffeine citrate reduced significantly the number of 5-to-10-second-long central apnea during the 30-minute periods (12±11 to 7±7; p=0.02). Caffeine citrate increased both peak and phasic Edi leading to a significant increase in the diaphragm energy expenditure. Edi signal can be reliably measured and processed to study changes in premature infants' neural breathing. The beneficial effect of caffeine citrate on the reduction of the number of apnea is mediated through stimulated neural breathing increasing the diaphragm energy expenditure. •Edi signal can be reliably measured to study premature infants' neural breathing.•Caffeine citrate reduces the number of central apnea in preterm infants.•Caffeine citrate increases peak and phasic electrical activity of the diaphragm.•Diaphragm energy expenditure is increased after caffeine citrate loading.
Bibliografia:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:0378-3782
1872-6232
1872-6232
DOI:10.1016/j.earlhumdev.2015.06.007