Effects of Single Loading Dose of Intravenous Caffeine on Cerebral Oxygenation in Preterm Infants

Ilhan O., Bor M.

AMERICAN JOURNAL OF PERINATOLOGY, cilt.38, 2021 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 38
  • Basım Tarihi: 2021
  • Doi Numarası: 10.1055/s-0040-1708490
  • Dergi Adı: AMERICAN JOURNAL OF PERINATOLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, CINAHL, EMBASE, MEDLINE, Veterinary Science Database
  • İstanbul Üniversitesi Adresli: Hayır

Özet

Objective The aim of this study was to evaluate the effects of caffeine on cerebral oxygenation in preterm infants. Study Design This was a prospective study of infants with a gestational age (GA) of<34 weeks who were treated intravenously with a loading dose of 20mg/kg caffeine citrate within the first 48hours of life. Regional cerebral oxygen saturation (rSO (2) C) and cerebral fractional tissue oxygen extraction (cFTOE) were measured using near-infrared spectroscopy before administering caffeine (baseline), immediately after administering caffeine, and 1, 2, 3, 4, 6, and 12hours after dose completion; postdose values were compared with the baseline values. Results A total of 48 infants with a mean GA of 29.01.9 weeks, birth weight of 1,286301g, and postnatal age of 32.4 +/- 11.3hours were included in the study. rSO (2) C significantly decreased from 81.3 to 76.7% soon after administering caffeine, to 77.1% at 1 hour, and to 77.8% at 2hours with recovery at 3hours postdose. rSO (2) C was 80.2% at 12hours postdose. cFTOE increased correspondingly. Although rSO (2) C values were lower and cFTOE values were higher compared with the baseline values at 3, 4, 6, and 12hours after caffeine administration, this was not statistically significant. Conclusion A loading dose of caffeine temporarily reduces cerebral oxygenation and increases cerebral tissue oxygen extraction in preterm infants. Most probably these changes reflect a physiological phenomenon without any clinical importance to the cerebral hemodynamics, as the reduction in cerebral oxygenation and increase in cerebral tissue oxygen extraction remain well within acceptable range.