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Caffeine in premature infants

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https://www.readbyqxmd.com/read/27899304/caffeine-for-apnea-of-prematurity-effects-on-the-developing-brain
#1
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...
November 27, 2016: Neurotoxicology
https://www.readbyqxmd.com/read/27760427/doxapram-treatment-for-apnea-of-prematurity-a-systematic-review
#2
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...
October 20, 2016: Neonatology
https://www.readbyqxmd.com/read/27725928/association-between-apnea-of-prematurity-and-respiratory-distress-syndrome-in-late-preterm-infants-an-observational-study
#3
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
#4
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
#5
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...
August 15, 2016: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27398705/apnea-after-routine-eye-examinations-in-premature-infants
#6
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...
July 11, 2016: 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
#7
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
https://www.readbyqxmd.com/read/27242907/timing-of-caffeine-therapy-and-neonatal-outcomes-in-preterm-infants-a-retrospective-study
#8
Ivan Hand, Nahla Zaghloul, Lily Barash, Rudolph Parris, Ulrika Aden, Hsiu-Ling Li
Background. Caffeine is widely used to treat apnea of prematurity. Here, we evaluated the efficacy of early caffeine (1-2 DOL) in decreasing the incidence of adverse neonatal outcomes. Methods. A retrospective cohort was used to compare the neonatal morbidity of 150 preterm neonates with gestational age ≤29 weeks. Infants were divided into 3 groups based on the initiation timing of caffeine therapy; (1) early caffeine (1-2 DOL), (2) late caffeine (3-7 DOL), and (3) very late caffeine (≥8 DOL). Results. The neonatal outcomes of early caffeine were comparable with those of the late caffeine group...
2016: International Journal of Pediatrics
https://www.readbyqxmd.com/read/26982450/mechanisms-of-modulation-of-cytokine-release-by-human-cord-blood-monocytes-exposed-to-high-concentrations-of-caffeine
#9
Raul Chavez-Valdez, Rajni Ahlawat, Marsha Wills-Karp, Estelle B Gauda
BACKGROUND: Serum caffeine concentrations >20 μg/ml (100 μmol/l) in infants treated for apnea of prematurity increases TNF-α and decreases IL-10, changes that perhaps are linked to comorbidities. We hypothesize that this proinflammatory cytokine profile may be linked to differential binding of caffeine to adenosine receptor subtypes (AR), inhibition of phosphodiesterases (PDEs), and modulation of toll-like receptors (TLR). METHODS: Lipopolysaccharide-activated cord blood monocytes (CBM) from 19 infants were exposed to caffeine (0-200 μmol/l) with or without previous exposure to A1R, A3R, or PDE IV antagonists to determine changes in dose-response curves...
July 2016: Pediatric Research
https://www.readbyqxmd.com/read/26976495/caffeine-administration-to-prevent-apnea-in-very-premature-infants
#10
Amir-Mohammad Armanian, Ramin Iranpour, Eiman Faghihian, Nima Salehimehr
BACKGROUND: Apnea intervals frequently occur in premature infants. Periods of apnea occur more often with decreases in gestational age. Periods of apnea can cause damage to the infant's developing brain and other organs. This study was designed to investigate the preventive effects of caffeine on apnea incidence in higher-risk neonates. METHODS: In this single-center randomized control trial study, premature infants with a birth weight of ≤1200 g were eligible for enrollment...
January 28, 2016: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/26899133/coffee-caffeine-and-sleep-a-systematic-review-of-epidemiological-studies-and-randomized-controlled-trials
#11
Ian Clark, Hans Peter Landolt
Caffeine is the most widely consumed psychoactive substance in the world. It is readily available in coffee and other foods and beverages, and is used to mitigate sleepiness, enhance performance, and treat apnea in premature infants. This review systematically explores evidence from epidemiological studies and randomized controlled trials as to whether coffee and caffeine have deleterious effects on sleep. Caffeine typically prolonged sleep latency, reduced total sleep time and sleep efficiency, and worsened perceived sleep quality...
January 30, 2016: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/26831641/pharmacologic-interventions-for-the-prevention-and-treatment-of-retinopathy-of-prematurity
#12
REVIEW
Kay D Beharry, Gloria B Valencia, Douglas R Lazzaro, Jacob V Aranda
Retinopathy of prematurity (ROP), a significant morbidity in prematurely born infants, is the most common cause of visual impairment and blindness in children and persists till adulthood. Strict control of oxygen therapy and prevention of intermittent hypoxia are the keys in the prevention of ROP, but pharmacologic interventions have decreased risk of ROP. Various drug classes such as methylxanthines (caffeine), VEGF inhibitors, antioxidants, and others have decreased ROP occurrence. The timing of pharmacologic intervention remains unsettled, but early prevention rather than controlling disease progression may be preferred...
April 2016: Seminars in Perinatology
https://www.readbyqxmd.com/read/26820884/the-real-world-routine-use-of-caffeine-citrate-in-preterm-infants-a-european-postauthorization-safety-study
#13
MULTICENTER STUDY
Gianluca Lista, Laura Fabbri, Renáta Polackova, Ursula Kiechl-Kohlendorfer, Konstantinos Papagaroufalis, Pilar Saenz, Fania Ferrari, Giovanna Lasagna, Virgilio P Carnielli
BACKGROUND: Caffeine citrate is the treatment of choice for apnea of prematurity (AOP). Regulatory agencies have requested real-world data on drug utilization and safety, a postauthorization safety study, of a pharmaceutical-grade caffeine citrate, Peyona, to confirm its benefit for preterm infants. OBJECTIVES: To investigate the clinical use, outcomes, and safety profile of this pharmaceutical-grade caffeine citrate in the routine treatment of preterm infants with a gestational age (GA) <37 weeks...
2016: Neonatology
https://www.readbyqxmd.com/read/26757002/evaluation-of-caffeine-and-the-development-of-necrotizing-enterocolitis
#14
C Cox, N G Hashem, J Tebbs, P Brandon Bookstaver, V Iskersky
OBJECTIVE: To test the association between medical or surgical necrotizing enterocolitis (NEC) and caffeine administration in premature infants. STUDY DESIGN: This single-center, retrospective study evaluated patients admitted to a level 3 neonatal intensive care unit (NICU) over an 18-month period. All patients were evaluated for factors associated with the development of NEC including exposure to caffeine (dosing and duration), gestational age, birth weight, vasoactive medications and maternal illicit drug use...
2015: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/26583943/cardiorespiratory-events-in-preterm-infants-interventions-and-consequences
#15
J M Di Fiore, C F Poets, E Gauda, R J Martin, P MacFarlane
Stabilization of respiration and oxygenation continues to be one of the main challenges in clinical care of the neonate. Despite aggressive respiratory support including mechanical ventilation, continuous positive airway pressure, oxygen and caffeine therapy to reduce apnea and accompanying intermittent hypoxemia, the incidence of intermittent hypoxemia events continues to increase during the first few months of life. Even with improvements in clinical care, standards for oxygen saturation targeting and modes of respiratory support have yet to be identified in this vulnerable infant cohort...
April 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/26566480/caffeine-therapy-in-preterm-infants
#16
REVIEW
Hesham Abdel-Hady, Nehad Nasef, Abd Elazeez Shabaan, Islam Nour
Caffeine is the most commonly used medication for treatment of apnea of prematurity. Its effect has been well established in reducing the frequency of apnea, intermittent hypoxemia, and extubation failure in mechanically ventilated preterm infants. Evidence for additional short-term benefits on reducing the incidence of bronchopulmonary dysplasia and patent ductus arteriosus has also been suggested. Controversies exist among various neonatal intensive care units in terms of drug efficacy compared to other methylxanthines, dosage regimen, time of initiation, duration of therapy, drug safety and value of therapeutic drug monitoring...
November 8, 2015: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/26562367/apnea-of-prematurity-and-caffeine-pharmacokinetics-potential-impact-on-hospital-discharge
#17
J Doyle, D Davidson, S Katz, M Varela, D Demeglio, J DeCristofaro
OBJECTIVE: To determine the half-life of serum caffeine concentrations and its relation to apnea of prematurity (AOP) after caffeine is discontinued in preparation for hospital discharge. STUDY DESIGN: Prospective cohort study involving preterm infants with gestational ages ⩽33 weeks at birth. After caffeine was discontinued, serum caffeine concentrations and electronic detection of pathologic apnea, defined a priori, were obtained at 24 and 168 h, respectively...
February 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/26318030/prediction-of-late-death-or-disability-at-age-5-years-using-a-count-of-3-neonatal-morbidities-in-very-low-birth-weight-infants
#18
MULTICENTER STUDY
Barbara Schmidt, Robin S Roberts, Peter G Davis, Lex W Doyle, Elizabeth V Asztalos, Gillian Opie, Aida Bairam, Alfonso Solimano, Shmuel Arnon, Reginald S Sauve
OBJECTIVE: To evaluate bronchopulmonary dysplasia (BPD), serious brain injury, and severe retinopathy of prematurity (ROP) as predictors of poor long-term outcome in very low birth weight infants. STUDY DESIGN: We examined the associations between counts of the 3 morbidities and long-term outcomes in 1514 of 1791 (85%) infants with birth weights of 500-1250 g who were enrolled in the Caffeine for Apnea of Prematurity trial from October 1999, to October 2004, had complete morbidity data, and were alive at 36 weeks postmenstrual age (PMA)...
November 2015: Journal of Pediatrics
https://www.readbyqxmd.com/read/26303483/an-overview-on-the-respiratory-stimulant-effects-of-caffeine-and-progesterone-on-response-to-hypoxia-and-apnea-frequency-in-developing-rats
#19
REVIEW
Aida Bairam, NaggaPraveena Uppari, Sébastien Mubayed, Vincent Joseph
The respiratory stimulant caffeine is the most frequently used xanthine (theophylline or aminophylline) for the treatment of apnea in premature infants. It decreases but does not eliminate apnea. In most cases such decreases is insufficient to prevent the use of artificial ventilation. Progesterone is a respiratory stimulant in adult mammals including human, and it decreases sleep apnea in menopausal women. Whether progesterone as an adjunct to caffeine therapy could be effective in further reducing the frequency of apnea in premature infants is not known because its respiratory effect in newborns has not been well studied...
2015: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/26217936/the-effect-of-caffeine-citrate-on-neural-breathing-pattern-in-preterm-infants
#20
Vilhelmiina Parikka, Jennifer Beck, Qian Zhai, Juha Leppäsalo, Liisa Lehtonen, Hanna Soukka
BACKGROUND: Caffeine citrate is widely used to prevent and treat prematurity-associated apnea. AIMS: 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. STUDY DESIGN: 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...
October 2015: Early Human Development
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