The effect of caffeine citrate on neural breathing pattern in preterm infants. Issue 10 (October 2015)

• Record Type: Journal Article
• Authors: Parikka, Vilhelmiina; Beck, Jennifer; Zhai, Qian; Leppäsalo, Juha; Lehtonen, Liisa; Soukka, Hanna
• Is Part Of: Early human development. Volume 91:Issue 10(2015)
• Page Start: 565
• Page End: 568
• Publication Date: 2015-10
• Subjects: Fetus -- Periodicals; Neonatology -- Periodicals; Prenatal influences -- Periodicals; 612.65
• DOI: 10.1016/j.earlhumdev.2015.06.007
• Languages: English
• ISSNs: 0378-3782

Abstract

<abstract abstract-type="author" id="ab0005"> <title id="st0005">Abstract</title> <sec> <title id="st0010">Background</title> <p id="sp0005">Caffeine citrate is widely used to prevent and treat prematurity-associated apnea.</p> </sec> <sec> <title id="st0015">Aims</title> <p id="sp0010">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.</p> </sec> <sec> <title id="st0020">Study design</title> <p id="sp0015">Preterm infants were evaluated for 30 min before and 30 min after caffeine citrate loading (20 mg/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 > 5 s.</p> </sec> <sec> <title id="st0025">Subjects</title> <p id="sp0020">Seventeen preterm infants with a mean age of three days and mean birth weight of 900 grams were evaluated.</p> </sec> <sec> <title id="st0030">Outcome measures</title> <p id="sp0025">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.</p> </sec> <sec> <title id="st0035">Results</title> <p id="sp0030">The majority of the apnea were short (5 to 10 s) 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.</p> </sec> <sec> <title id="st0040">Conclusions</title> <p id="sp0035">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.</p> </sec> </abstract>