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Caffeine in premature infants

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https://www.readbyqxmd.com/read/28875061/impact-of-caffeine-boluses-and-caffeine-discontinuation-on-apnea-and-hypoxemia-in-preterm-infants
#1
Christa R Tabacaru, Suk Young Jang, Manisha Patel, Faranek Davalian, Santina Zanelli, Karen D Fairchild
Background: Apnea of prematurity often occurs during and following caffeine therapy. We hypothesized that number of apnea events would be impacted by adjustments in caffeine therapy. Materials and Methods: An automated algorithm was used in all infants ≤32 weeks gestation admitted to a level IV Neonatal Intensive Care Unit from 2009 to 2014 to analyze chest impedance, electrocardiogram, and oxygen saturation data around the time of serum caffeine levels, caffeine boluses while on maintenance therapy, and caffeine discontinuation...
September 1, 2017: Journal of Caffeine Research
https://www.readbyqxmd.com/read/28854518/intestinal-perforation-in-the-premature-infant
#2
K Ongbhavit, M A Underwood
OBJECTIVE: To compare demographic data, prenatal and postnatal characteristics, laboratory data, and outcomes in a cohort of premature infants with spontaneous ileal perforation (SIP), surgical necrotizing enterocolitis (sNEC) and matched controls. METHODS: A retrospective case-control study of infants with intestinal perforation with a birth weight (BW) less than 2,000 grams and gestational age (GA) less than 34 weeks and infants without perforation matched for BW (±150 grams) and GA (±1week)...
August 23, 2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28774356/prevention-of-bronchopulmonary-dysplasia-current-strategies
#3
Deepak Jain, Eduardo Bancalari
Bronchopulmonary dysplasia (BPD) is one of the few diseases affecting premature infants that have continued to evolve since its first description about half a century ago. The current form of BPD, a more benign and protracted respiratory failure in extremely preterm infants, is in contrast to the original presentation of severe respiratory failure with high mortality in larger premature infants. This new BPD is end result of complex interplay of various antenatal and postnatal factors causing lung injury and subsequent abnormal repair leading to altered alveolar and vascular development...
August 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28697724/early-characteristics-of-infants-with-pulmonary-hypertension-in-a-referral-neonatal-intensive-care-unit
#4
Shilpa Vyas-Read, Usama Kanaan, Prabhu Shankar, Jane Stremming, Curtis Travers, David P Carlton, Anne Fitzpatrick
BACKGROUND: Approximately 8-23% of premature infants develop pulmonary hypertension (PH), and this diagnosis confers a higher possibility of mortality. As a result, professional societies recommend PH screening in premature infants. However, the risk factors for and the outcomes of PH may differ depending on the timing of its diagnosis, and little evidence is available to determine at-risk infants in the referral neonatal population. The objective of this study was to define clinical and echocardiographic characteristics of infants with pulmonary hypertension during the neonatal hospital course and at or near-term...
July 11, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28689383/-apnea-of-prematurity-characteristic-and-treatment
#5
Aleksandra Goryniak, Angelika Szczęśniak, Daria Śleboda, Barbara Dołęgowska
Apnea of prematurity (AOP) can affect even 85-100% of premature newborns and is related to lack of full maturity of organs. AOP is manifesting by 15-20 seconds cessations of breathing accompanied by bradycardia and oxygen desaturation, what can lead to hypoxia or death. Therefore it is very important to implement the effective and safe treatment immediately after birth. Widely used caffeine citrate, which stimulates the respiratory system, improving the working of the respiratory muscles. However the metabolism of caffeine citrate is difficult in preterm infants due to the immaturity of the hepatic enzyme system, what can lead to the occurrence of side effects and toxicity...
2017: Postepy Biochemii
https://www.readbyqxmd.com/read/28474588/comparative-efficacy-and-safety-of-caffeine-and-aminophylline-for-apnea-of-prematurity-in-preterm-%C3%A2-34-weeks-neonates-a-randomized-controlled-trial
#6
RANDOMIZED CONTROLLED TRIAL
M Shivakumar, P Jayashree, Muhammad Najih, Leslie Edward Simon Lewis, Ramesh Bhat Y, Asha Kamath, - Shashikala
OBJECTIVE: To compare the efficacy and safety of standard doses of Caffeine and Aminophylline for Apnea of prematurity. STUDY DESIGN: Randomized controlled trial. SETTING: Tertiary-care referral centre and a teaching institution in Southern India. Trial was conducted from February 2012 to January 2015. PARTICIPANTS: 240 preterm (≤34 wk) neonates with apnea of prematurity. INTERVENTIONS: Neonates randomized into two groups: Caffeine group received loading dose of caffeine citrate (20 mg/kg) followed by 5 mg/kg/day maintenance dose every 24 hour...
April 15, 2017: Indian Pediatrics
https://www.readbyqxmd.com/read/28420694/caffeine-preferentially-protects-against-oxygen-induced-retinopathy
#7
Shuya Zhang, Rong Zhou, Bo Li, Haiyan Li, Yanyan Wang, Xuejiao Gu, Lingyun Tang, Cun Wang, Dingjuan Zhong, Yuanyuan Ge, Yuqing Huo, Jing Lin, Xiao-Ling Liu, Jiang-Fan Chen
Retinopathy of prematurity (ROP) is the leading cause of childhood blindness, but current anti-VEGF therapy is concerned with delayed retinal vasculature, eye, and brain development of preterm infants. The clinical observation of reduced ROP severity in premature infants after caffeine treatment for apnea suggests that caffeine may protect against ROP. Here, we demonstrate that caffeine did not interfere with normal retinal vascularization development but selectively protected against oxygen-induced retinopathy (OIR) in mice...
April 18, 2017: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
https://www.readbyqxmd.com/read/28399119/caffeine-ameliorates-hyperoxia-induced-lung-injury-by-protecting-gch1-function-in-neonatal-rat-pups
#8
Xigang Jing, Yi-Wen Huang, Jason Jarzembowski, Yang Shi, Girija G Konduri, Ru-Jeng Teng
BackgroundBronchopulmonary dysplasia (BPD) is a major morbidity in premature infants, and impaired angiogenesis is considered a major contributor to BPD. Early caffeine treatment decreases the incidence of BPD; the mechanism remains incompletely understood.MethodsSprague-Dawley rat pups exposed to normoxia or hyperoxia since birth were treated daily with either 20 mg/kg caffeine or normal saline by an intraperitoneal injection from day 2 of life. The lungs were obtained for studies at days 10 and 21.ResultsHyperoxia impaired somatic growth and lung growth in the rat pups...
September 2017: Pediatric Research
https://www.readbyqxmd.com/read/28213471/attenuation-of-endoplasmic-reticulum-stress-by-caffeine-ameliorates-hyperoxia-induced-lung-injury
#9
Ru-Jeng Teng, Xigang Jing, Teresa Michalkiewicz, Adeleye J Afolayan, Tzong-Jin Wu, Girija G Konduri
Rodent pups exposed to hyperoxia develop lung changes similar to bronchopulmonary dysplasia (BPD) in extremely premature infants. Oxidative stress from hyperoxia can injure developing lungs through endoplasmic reticulum (ER) stress. Early caffeine treatment decreases the rate of BPD, but the mechanisms remain unclear. We hypothesized that caffeine attenuates hyperoxia-induced lung injury through its chemical chaperone property. Sprague-Dawley rat pups were raised either in 90 (hyperoxia) or 21% (normoxia) oxygen from postnatal day 1 (P1) to postnatal day 10 (P10) and then recovered in 21% oxygen until P21...
May 1, 2017: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/28106777/neuroprotection-by-caffeine-in-hyperoxia-induced-neonatal-brain-injury
#10
Stefanie Endesfelder, Ulrike Weichelt, Evelyn Strauß, Anja Schlör, Marco Sifringer, Till Scheuer, Christoph Bührer, Thomas Schmitz
Sequelae of prematurity triggered by oxidative stress and free radical-mediated tissue damage have coined the term "oxygen radical disease of prematurity". Caffeine, a potent free radical scavenger and adenosine receptor antagonist, reduces rates of brain damage in preterm infants. In the present study, we investigated the effects of caffeine on oxidative stress markers, anti-oxidative response, inflammation, redox-sensitive transcription factors, apoptosis, and extracellular matrix following the induction of hyperoxia in neonatal rats...
January 18, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28088487/adenosine-receptors-and-caffeine-in-retinopathy-of-prematurity
#11
REVIEW
Jiang-Fan Chen, Shuya Zhang, Rong Zhou, Zhenlang Lin, Xiaohong Cai, Jing Lin, Yuqing Huo, Xiaoling Liu
Retinopathy of prematurity (ROP) is a major cause of childhood blindness in the world and is caused by oxygen-induced damage to the developing retinal vasculature, resulting in hyperoxia-induced vaso-obliteration and subsequent delayed retinal vascularization and hypoxia-induced pathological neovascularization driven by vascular endothelial growth factor (VEGF) signaling pathway in retina. Current anti-VEGF therapy has shown some effective in a clinical trial, but is associated with the unintended effects on delayed eye growth and retinal vasculature development of preterm infants...
June 2017: Molecular Aspects of Medicine
https://www.readbyqxmd.com/read/28003553/economics-of-home-monitoring-for-apnea-in-late-preterm-infants
#12
Brian L Montenegro, Michael Amberson, Lauren Veit, Christina Freiberger, Dmitry Dukhovny, Lawrence M Rhein
BACKGROUND: Apnea of prematurity affects a small proportion but large absolute number of late preterm infants, with out-patient management variably utilized despite relative clinical equipoise and potential for improved cost-effectiveness. METHODS: Over a 5-y period, from 2009 to 2013, infants born at ≥34 weeks gestational age at a level IIIB academic center in Boston, Massachusetts, with discharge-delaying apnea, bradycardia, and desaturation (ABD) events were identified...
January 2017: Respiratory Care
https://www.readbyqxmd.com/read/27924651/caffeine-combined-with-sedative-anesthetic-drugs-triggers-widespread-neuroapoptosis-in-a-mouse-model-of-prematurity
#13
Omar Hoseá Cabrera, Shawn David O'Connor, Brant Stephen Swiney, Patricia Salinas-Contreras, Francesca Maria Manzella, George Townsend Taylor, Kevin Kiyoshi Noguchi
OBJECTIVES: Caffeine (CAF) and sedative/anesthetic drugs (SADs) are often coadministered to premature infants in the neonatal intensive care unit (NICU). While SAD neurotoxicity in the developing brain is well established, it is not fully clear whether CAF interacts with SADs and whether this interaction is detrimental. Using a mouse model of prematurity, we hypothesized that CAF would increase apoptotic neurotoxicity when coadministered with SADs. METHODS: Postnatal day 3 mice were treated with vehicle or 80 mg/kg CAF prior to challenge with 6 mg/kg midazolam, 40 mg/kg ketamine, or 40 μg/kg fentanyl...
November 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27899304/caffeine-for-apnea-of-prematurity-effects-on-the-developing-brain
#14
REVIEW
Anzari Atik, Richard Harding, Robert De Matteo, Delphi Kondos-Devcic, Jeanie Cheong, Lex W Doyle, Mary Tolcos
Caffeine is a methylxanthine that is widely used to treat apnea of prematurity (AOP). In preterm infants, caffeine reduces the duration of respiratory support, improves survival rates and lowers the incidence of cerebral palsy and cognitive delay. There is, however, little evidence relating to the immediate and long-term effects of caffeine on brain development, especially at the cellular and molecular levels. Experimental data are conflicting, with studies showing that caffeine can have either adverse or benefical effects in the developing brain...
January 2017: Neurotoxicology
https://www.readbyqxmd.com/read/27760427/doxapram-treatment-for-apnea-of-prematurity-a-systematic-review
#15
Roseanne J S Vliegenthart, Christine H Ten Hove, Wes Onland, Anton H L C van Kaam
BACKGROUND: Apnea of prematurity (AOP) is a common complication of preterm birth, for which caffeine is the first treatment of choice. In case of persistent AOP, doxapram has been advocated as an additional therapy. OBJECTIVE: To identify and appraise all existing evidence regarding efficacy and safety of doxapram use for AOP in infants born before 34 weeks of gestational age. METHODS: All studies reporting on doxapram use for AOP were identified by searching electronic databases, references from relevant studies, and abstracts from the Societies for Pediatric Research...
2017: Neonatology
https://www.readbyqxmd.com/read/27725928/association-between-apnea-of-prematurity-and-respiratory-distress-syndrome-in-late-preterm-infants-an-observational-study
#16
François Olivier, Sophie Nadeau, Georges Caouette, Bruno Piedboeuf
BACKGROUND: Late preterm infants (34-36 weeks' gestation) remain a population at risk for apnea of prematurity (AOP). As infants affected by respiratory distress syndrome (RDS) have immature lungs, they might also have immature control of breathing. Our hypothesis is that an association exists between RDS and AOP in late preterm infants. OBJECTIVE: The primary objective of this study was to assess the association between RDS and AOP in late preterm infants. The secondary objective was to evaluate if an association exists between apparent RDS severity and AOP...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27612991/doxapram-dosing-for-apnea-of-prematurity-based-on-postmenstrual-age-and-gender-a-randomized-controlled-trial
#17
RANDOMIZED CONTROLLED TRIAL
E Greze, M Benard, I Hamon, C Casper, F E Haddad, M-J Boutroy, J-M Hascoët
INTRODUCTION: Doxapram is used as a third-line treatment for apnea unresponsive to caffeine and continuous positive airway pressure (CPAP) in preterm infants. OBJECTIVES: The objectives of this study were to compare the effects of dosing adjusted for gender and postmenstrual age (PMA) (GrA) versus infants' weight alone (GrW) on doxapram plasma levels, clinical efficacy, and side effects. METHODS: This was a randomized, double-blind study, including premature infants for whom optimized caffeine and CPAP therapy for apnea of prematurity had failed...
December 2016: Paediatric Drugs
https://www.readbyqxmd.com/read/27526255/systematic-review-and-meta-analysis-of-clinical-outcomes-of-early-caffeine-therapy-in-preterm-neonates
#18
REVIEW
Kok Pim Kua, Shaun Wen Huey Lee
AIMS: This study evaluated the therapeutic outcomes of early versus late caffeine therapy in preterm neonates. METHODS: We performed a systematic literature search in PubMed, Embase, CINAHL and CENTRAL from inception to 30 June 2016 to identify studies investigating the use of early caffeine therapy (initiated at less than 3 days of life) in preterm infants. Effect estimates were combined using random-effects meta-analysis. The primary outcomes for this study were bronchopulmonary dysplasia and mortality...
January 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27398705/apnea-after-routine-eye-examinations-in-premature-infants
#19
Brittany Reid, Hongyue Wang, Ronnie Guillet
Objective To determine the frequency of cardiorespiratory events following routine exams for retinopathy of prematurity (ROP). Study Design This is a retrospective review of 79 premature infants in the neonatal intensive care unit at the University of Rochester Medical Center. The baseline for each infant (mean cardiorespiratory events in the 72 hours before the exam) was compared with the number of cardiorespiratory events during the subsequent 24 hours using generalized estimating equation and the Mantel-Haenszel chi-square test to determine if there was an association between cardiorespiratory events and potential risk factors...
January 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/27304988/neuromodulation-of-limb-proprioceptive-afferents-decreases-apnea-of-prematurity-and-accompanying-intermittent-hypoxia-and-bradycardia
#20
RANDOMIZED CONTROLLED TRIAL
Kalpashri Kesavan, Paul Frank, Daniella M Cordero, Peyman Benharash, Ronald M Harper
BACKGROUND: Apnea of Prematurity (AOP) is common, affecting the majority of infants born at <34 weeks gestational age. Apnea and periodic breathing are accompanied by intermittent hypoxia (IH). Animal and human studies demonstrate that IH exposure contributes to multiple pathologies, including retinopathy of prematurity (ROP), injury to sympathetic ganglia regulating cardiovascular action, impaired pancreatic islet cell and bone development, cerebellar injury, and neurodevelopmental disabilities...
2016: PloS One
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