Impact of early caffeine therapy in preterm newborns on infant lung function

Sánchez-Solís, Manuel Rolandi; García-Marcos, Patricia W.; Agüera‐Arenas, Juan; Mondéjar-López, Pedro; García‐Marcos, Luis

doi:10.1002/ppul.24540

Cited by 17 publications

(9 citation statements)

References 22 publications

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“…Many other perinatal factors have been identified as important factors predicting adverse lung function in childhood. These include but are not limited to antenatal steroids, maternal nutrition, maternal pregnancy disorders (hypertensive disorders, gestational diabetes, chorioamnionitis), parental smoking, socioeconomic status, IUGR, sex, and neonatal caffeine administration ( 12 , 37 , 38 ). However, we did not find an association between these factors and lung function.…”

Section: Discussionmentioning

confidence: 99%

Reduced Lung Function at Preschool Age in Survivors of Very Low Birth Weight Preterm Infants

Chang

Chi

et al. 2020

Front. Pediatr.

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Background: Survivors of preterm birth are at risk of long-term respiratory consequences. The objective of this prospective study was to assess pulmonary function at preschool age of former very low birth weight (VLBW) preterm children. Methods: Lung function of children born preterm and term controls aged 5–6 years were assessed by spirometry. The results were converted to z-scores. A questionnaire regarding respiratory symptoms was completed. Associations to gestational age (GA), birth weight (BW), bronchopulmonary dysplasia (BPD), and perinatal factors were assessed. Results: In total, 85 VLBW preterm children and 29 term controls were studied. Of the preterm children, the mean GA was 28.6 ± 2.6 weeks and the mean BW was 1,047 ± 273 gm. Preterm children had significantly lower z-scores of forced expiratory volume in 1 s (FEV 1 ), FEV 1 /forced vital capacity (FVC) ratio, and forced expiratory flow rate between 25–75% of FVC (FEF 25−75 ), compared with term controls (−0.73 vs. 0.04, p = 0.002; −0.22 vs. 0.39, p = 0.003; −0.93 vs. 0.0, p < 0.001; respectively). Further segregation of the preterm group revealed significantly impaired FEV 1 , FEF 25−75 in children at earlier gestation (≤ 28 weeks, n = 45), lighter at birth (≤ 1,000 g, n = 38), or with BPD ( n = 55) compared with term controls ( p < 0.05). There were significant negative relationships between the severity of BPD with FEV 1 , FVC, and FEF 25−75 ( p < 0.05). However, no correlation between lung function measurements and respiratory symptoms was found. Conclusions: VLBW preterm infants have reduced lung function at preschool age, especially among those with younger GA, lower BW, and BPD. Additional long-term follow-up of respiratory outcomes are needed for this vulnerable population.

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Section: Discussionmentioning

confidence: 99%

Reduced Lung Function at Preschool Age in Survivors of Very Low Birth Weight Preterm Infants

Chang

Chi

et al. 2020

Front. Pediatr.

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“…A small but beneficial effect of vitamin A in lowering rates of BPD has been found in preterm neonates born before 29 weeks' gestation [ 17 , 18 ]. Data from initial clinical studies of caffeine therapy show a reduction in BPD rates [ 19 , 20 ] and significant improvement of lung function [ 21 ]. The discussed early prophylactic caffeine treatment before extubation is partly associated with a reduced incidence of BPD [ 22 – 24 ] but also linked with a higher mortality compared to a later start of caffeine administration (>3 postnatal days) [ 25 , 26 ].…”

Section: Introductionmentioning

confidence: 99%

Prevention of Oxygen-Induced Inflammatory Lung Injury by Caffeine in Neonatal Rats

Endesfelder

Strauss

Bendix

et al. 2020

Oxidative Medicine and Cellular Longevity

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Background. Preterm birth implies an array of respiratory diseases including apnea of prematurity and bronchopulmonary dysplasia (BPD). Caffeine has been introduced to treat apneas but also appears to reduce rates of BPD. Oxygen is essential when treating preterm infants with respiratory problems but high oxygen exposure aggravates BPD. This experimental study is aimed at investigating the action of caffeine on inflammatory response and cell death in pulmonary tissue in a hyperoxia-based model of BPD in the newborn rat. Material/Methods. Lung injury was induced by hyperoxic exposure with 80% oxygen for three (P3) or five (P5) postnatal days with or without recovery in ambient air until postnatal day 15 (P15). Newborn Wistar rats were treated with PBS or caffeine (10 mg/kg) every two days beginning at the day of birth. The effects of caffeine on hyperoxic-induced pulmonary inflammatory response were examined at P3 and P5 immediately after oxygen exposure or after recovery in ambient air (P15) by immunohistological staining and analysis of lung homogenates by ELISA and qPCR. Results. Treatment with caffeine significantly attenuated changes in hyperoxia-induced cell death and apoptosis-associated factors. There was a significant decrease in proinflammatory mediators and redox-sensitive transcription factor NFκB in the hyperoxia-exposed lung tissue of the caffeine-treated group compared to the nontreated group. Moreover, treatment with caffeine under hyperoxia modulated the transcription of the adenosine receptor (Adora)1. Caffeine induced pulmonary chemokine and cytokine transcription followed by immune cell infiltration of alveolar macrophages as well as increased adenosine receptor (Adora1, 2a, and 2b) expression. Conclusions. The present study investigating the impact of caffeine on the inflammatory response, pulmonary cell degeneration and modulation of adenosine receptor expression, provides further evidence that caffeine acts as an antioxidative and anti-inflammatory drug for experimental oxygen-mediated lung injury. Experimental studies may broaden the understanding of therapeutic use of caffeine in modulating detrimental mechanisms involved in BPD development.

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“…Caffeine may alleviate BPD by improving lung function. For example, a clinical study on the effect of caffeine treatment on pulmonary function showed that early caffeine treatment led to a significant increase in FVC and forced expiratory volume at 0.5 s in preterm infants without BPD; this trend was also evident in preterm infants with BPD 38 . In addition, a previous study reported that a group of patients who weighed less than 1250 g at birth, and did not receive early caffeine treatment, had a lower of FEV1, FVC, and the forced expired flow from 25% to 75% of the FVC (FEF25%–75%) at 11 years of age 39 .…”

Section: Benefits Effects Of Caffeine In the Treatment Of Bpdmentioning

confidence: 99%

Caffeine and bronchopulmonary dysplasia: Clinical benefits and the mechanisms involved

Yuan

Yang

Lei

et al. 2022

Pediatric Pulmonology

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Bronchopulmonary dysplasia (BPD) is a chronic respiratory disease that occurs during the neonatal period and is commonly associated with prematurity. This condition results in a severe economic burden on society and the families involved. Caffeine is used not only for the treatment of apnea in prematurity, but also for the prevention of BPD. There are multiple clinical benefits of caffeine treatment, including improved extubation success, a reduced duration of mechanical ventilation, improved lung function, and a reduction of patent ductus arteriosus requiring treatment. These clinical benefits of caffeine for the treatment of BPD are supported by both clinical trials and evidence from animal models. However, the mechanism by which caffeine protects against BPD remains unclear. Here, we review the clinical value of caffeine in the prevention of BPD and its potential mechanisms of action, including anti‐inflammatory, antioxidant, antifibrotic, and antiapoptotic properties, the regulation of angiogenesis, and diuretic effects. Our aim is to provide a new theoretical basis for the clinical treatment of BPD.

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Impact of early caffeine therapy in preterm newborns on infant lung function

Cited by 17 publications

References 22 publications

Reduced Lung Function at Preschool Age in Survivors of Very Low Birth Weight Preterm Infants

Reduced Lung Function at Preschool Age in Survivors of Very Low Birth Weight Preterm Infants

Prevention of Oxygen-Induced Inflammatory Lung Injury by Caffeine in Neonatal Rats

Caffeine and bronchopulmonary dysplasia: Clinical benefits and the mechanisms involved

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