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Caffeine in premature infants

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https://www.readbyqxmd.com/read/29765059/postnatal-microstructural-developmental-trajectory-of-corpus-callosum-subregions-and-relationship-to-clinical-factors-in-very-preterm-infants
#1
Radhika Teli, Margaret Hay, Alexa Hershey, Manoj Kumar, Han Yin, Nehal A Parikh
Our objectives were to define the microstructural developmental trajectory of six corpus callosum subregions and identify perinatal clinical factors that influence early development of these subregions in very preterm infants. We performed a longitudinal cohort study of very preterm infants (32 weeks gestational age or younger) (N = 36) who underwent structural MRI and diffusion tensor imaging serially at four time points - before 32, 32, 38, and 52 weeks postmenstrual age. We divided the corpus callosum into six subregions, performed probabilistic tractography, and used linear mixed effects models to evaluate the influence of antecedent clinical factors on its microstructural growth trajectory...
May 15, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29740190/does-duration-of-caffeine-therapy-in-preterm-infants-born-%C3%A2-1250-g-at-birth-influence-neurodevelopmental-nd-outcomes-at-3-years-of-age
#2
A Lodha, Y Rabi, A Soraisham, J Dobry, Arijit Lodha, H Amin, E Al Awad, S Tang, A Sahai, V Bhandari
OBJECTIVE: To evaluate the effect of duration of caffeine use on long-term neurodevelopmental (ND) outcomes at 3 years corrected age (CA) in preterm infants with birthweights (BW) ≤ 1250 g. DESIGN/METHODS: All surviving infants with BW ≤ 1250 g admitted to the Foothills Medical Center neonatal intensive care unit (NICU) from January 2002 to December 2009 who received the first dose of caffeine in the first week of life and were followed up at three years CA were included in the study...
May 8, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29643070/neurobehavioral-outcomes-11-years-after-neonatal-caffeine-therapy-for-apnea-of-prematurity
#3
Ines M Mürner-Lavanchy, Lex W Doyle, Barbara Schmidt, Robin S Roberts, Elizabeth V Asztalos, Lorrie Costantini, Peter G Davis, Deborah Dewey, Judy D'Ilario, Ruth E Grunau, Diane Moddemann, Harvey Nelson, Arne Ohlsson, Alfonso Solimano, Win Tin, Peter J Anderson
BACKGROUND AND OBJECTIVES: Caffeine is effective in the treatment of apnea of prematurity. Although caffeine therapy has a benefit on gross motor skills in school-aged children, effects on neurobehavioral outcomes are not fully understood. We aimed to investigate effects of neonatal caffeine therapy in very low birth weight (500-1250 g) infants on neurobehavioral outcomes in 11-year-old participants of the Caffeine for Apnea of Prematurity trial. METHODS: Thirteen academic hospitals in Canada, Australia, Great Britain, and Sweden participated in this part of the 11-year follow-up of the double-blind, randomized, placebo-controlled trial...
April 11, 2018: Pediatrics
https://www.readbyqxmd.com/read/29593226/caffeine-augments-anesthesia-neurotoxicity-in-the-fetal-macaque-brain
#4
Kevin K Noguchi, Stephen A Johnson, Francesca M Manzella, Kobe L Masuoka, Sasha L Williams, Lauren D Martin, Gregory A Dissen, Chrysanthy Ikonomidou, Katie J Schenning, John W Olney, Ansgar M Brambrink
Caffeine is the most frequently used medication in premature infants. It is the respiratory stimulant of choice for apnea associated with prematurity and has been called the silver bullet in neonatology because of many proven benefits and few known risks. Research has revealed that sedative/anesthetic drugs trigger apoptotic death of neurons and oligodendrocytes in developing mammalian brains. Here we evaluated the influence of caffeine on the neurotoxicity of anesthesia in developing nonhuman primate brains...
March 28, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29519541/early-caffeine-and-weaning-from-mechanical-ventilation-in-preterm-infants-a-randomized-placebo-controlled-trial
#5
Cynthia M Amaro, Jose A Bello, Deepak Jain, Alexandra Ramnath, Carmen D'Ugard, Silvia Vanbuskirk, Eduardo Bancalari, Nelson Claure
OBJECTIVE: To evaluate in a randomized, double-blind, placebo-controlled trial the effect of early caffeine on the age of first successful extubation in preterm infants. STUDY DESIGN: Preterm infants born at 23-30 weeks of gestation requiring mechanical ventilation in the first 5 postnatal days were randomized to receive a 20 mg/kg loading dose followed by 5 mg/kg/day of caffeine or placebo until considered ready for extubation. The placebo group received a blinded loading dose of caffeine before extubation...
May 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29476789/behavioral-and-neuroanatomical-outcomes-in-a-rat-model-of-preterm-hypoxic-ischemic-brain-injury-effects-of-caffeine-and-hypothermia
#6
Molly Potter, Ted Rosenkrantz, R Holly Fitch
The current study investigated behavioral and post mortem neuroanatomical outcomes in Wistar rats with a neonatal hypoxic-ischemic (HI) brain injury induced on postnatal day 6 (P6; Rice-Vannucci HI method; Rice et al., 1981). This preparation models brain injury seen in premature infants (gestational age (GA) 32-35 weeks) based on shared neurodevelopmental markers at time of insult, coupled with similar neuropathologic sequelae (Rice et al., 1981; Workman et al., 2013). Clinically, HI insult during this window is associated with poor outcomes that include attention deficit hyperactivity disorder (ADHD), motor coordination deficits, spatial memory deficits, and language/learning disabilities...
February 21, 2018: International Journal of Developmental Neuroscience
https://www.readbyqxmd.com/read/29437799/high-versus-standard-dose-caffeine-for-apnoea-a-systematic-review
#7
Roos Vliegenthart, Martijn Miedema, Gerard J Hutten, Anton H van Kaam, Wes Onland
BACKGROUND: Placebo-controlled trials have shown that caffeine is highly effective in treating apnoea of prematurity and reduces the risk of bronchopulmonary dysplasia (BPD) and neurodevelopmental impairment (NDI). OBJECTIVE: To identify, appraise and summarise studies investigating the modulating effect of different caffeine dosages. METHODS: A systematic review identified all randomised controlled trials (RCTs) comparing a high versus a standard caffeine treatment regimen in infants with a gestational age <32 weeks, by searching the main electronic databases and abstracts of the Pediatric Academic Societies...
February 7, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29387319/the-efficacy-and-safety-of-two-different-doses-of-caffeine-in-respiratory-function-of-preterm-infants
#8
Fatemeh Faramarzi, Mohammadreza Shiran, Mohammadreza Rafati, Roya Farhadi, Ebrahim Salehifar, Maryam Nakhshab
Background: Caffeine is widely used for prevention of apnea and helps successful extubation from mechanical ventilation. It facilitates the transition from invasive to noninvasive support and reduces duration of continuous positive airway pressure (CPAP) in preterm infants. The optimum caffeine dose in preterm infants has not been well-studied in terms of benefits and risks. We compared efficacy and safety of once versus twice-daily caffeine dose in premature infants. Methods: This study was a randomized clinical trial conducted in Bu-Ali Sina Teaching Hospital, Sari...
2018: Caspian Journal of Internal Medicine
https://www.readbyqxmd.com/read/29386437/-comparative-study-of-the-efficacy-and-safety-of-caffeine-and-aminophylline-for-the-treatment-of-apnea-in-preterm-infants
#9
COMPARATIVE STUDY
Akane Nagasato, Masatoshi Nakamura, Hidetoshi Kamimura
 Methylxanthine is widely administered for the treatment of apnea of prematurity in many countries, and previous reports have clearly established that caffeine is effective for the treatment of apnea of prematurity. In Japan, caffeine has been available since December 2014. Thus, we compared the efficacy and safety of caffeine with that of aminophylline in our hospital. There was no significant difference between the caffeine group and aminophylline group regarding the characteristics of the study patients...
2018: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/29357829/caffeine-is-a-risk-factor-for-osteopenia-of-prematurity-in-preterm-infants-a-cohort-study
#10
Ebtihal Ali, Cheryl Rockman-Greenberg, Michael Moffatt, Michael Narvey, Martin Reed, Depeng Jiang
BACKGROUND: Caffeine, the most commonly used medication in Neonatal Intensive Care Units, has calciuric and osteoclastogenic effects. METHODS: To examine the association between the cumulative dose and duration of therapy of caffeine and osteopenia of prematurity, a retrospective cohort study was conducted including premature infants less than 31 weeks and birth weight less than 1500 g. Osteopenia of prematurity was evaluated using chest X-rays on a biweekly basis over 12 weeks of hospitalization...
January 22, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29346141/caffeine-controversies
#11
Samuel J Gentle, Colm P Travers, Waldemar A Carlo
PURPOSE OF REVIEW: Caffeine use in preterm infants has endured several paradigms: from standard of care to possible neurotoxin to one of the few medications for which there is evidence of bronchopulmonary dysplasia (BPD) risk reduction. The purpose of the review is to analyze this dynamic trajectory and discuss controversies that still remain after decades of caffeine use. RECENT FINDINGS: Following concerns for caffeine safety in preterm infants, a large randomized controlled trial demonstrated a reduction in BPD and treatment for patent ductus arteriosus...
April 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29295636/caffeine-prevents-bilirubin-induced-cytotoxicity-in-cultured-newborn-rat-astrocytes
#12
Mehmet Deliktaş, Hacer Ergin, Aydın Demiray, Hakan Akça, Özmert M A Özdemir, Mehmet Bülent Özdemir
OBJECTIVE: Unconjugated bilirubin (UCB) may cause neurotoxicity in preterm neonates due to immaturity of UGT1A1 leading to bilirubin accumulation in the brain. Caffeine used in the treatment of apnea of prematurity was reported to decrease mechanical ventilation requirement, the frequencies of bronchopulmonary dysplasia, patent ductus arteriosus, cerebral palsy and neurodevelopmental disorders in very low birth weight infants. However, the effect of caffeine on hyperbilirubinemia was not yet clarified...
January 2, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29286928/long-term-neurodevelopment-outcome-of-caffeine-versus-aminophylline-therapy-for-apnea-of-prematurity
#13
S Khurana, M Shivakumar, G V Sujith Kumar Reddy, P Jayashree, Y Ramesh Bhat, L E S Lewis
OBJECTIVE: Methylxanthines are the most commonly prescribed drug in neonatal setups. However, Clinicians show indecision in choosing the right agent for Apnea of Prematurity in most of the developing countries. Present study aimed to compare rate of mortality and survival with normal neurodevelopment outcome at 18 to 24 months of corrected age, between Caffeine- and Aminophylline-treated infants for apnea of prematurity. METHODS: 240 infants were randomly allocated to caffeine and aminophylline for apnea of prematurity during February 2012 to January 2015...
2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/29261723/shifting-the-boundaries-for-early-caffeine-initiation-in-neonatal-practice-results-of-a-prospective-multicenter-study-on-very-preterm-infants-with-respiratory-distress-syndrome
#14
MULTICENTER STUDY
Maria Katarzyna Borszewska-Kornacka, Roman Hożejowski, Magdalena Rutkowska, Ryszard Lauterbach
BACKGROUND: There is growing evidence that supports the benefits of early use of caffeine in preterm neonates with RDS; however, no formal recommendations specifying the exact timing of therapy initiation have been provided. OBJECTIVES: We compared neonatal outcomes in infants receiving early (initial dose on the 1st day of life) and late (initial dose on day 2+ of life) caffeine therapy. METHODS: Using data from a prospective, cohort study, we identified 986 infants ≤32 weeks' gestation with RDS and assessed the timing of caffeine therapy initiation, need for ventilatory support, mortality and incidence of typical complications of prematurity...
2017: PloS One
https://www.readbyqxmd.com/read/28875061/impact-of-caffeine-boluses-and-caffeine-discontinuation-on-apnea-and-hypoxemia-in-preterm-infants
#15
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
#16
K Vongbhavit, 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)...
2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28774356/prevention-of-bronchopulmonary-dysplasia-current-strategies
#17
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
#18
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
#19
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
#20
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
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