The efficacy of caffeine in the treatment of recurrent idiopathic apnea in premature infants

Murat, I.; Moriette, G; Blin, Mg; Couchard, M; Flouvat, B; Gamarra, E. De; Relier, J P; Dreyfus-Brisac, C

doi:10.1016/s0022-3476(81)80038-8

Cited by 66 publications

(27 citation statements)

References 29 publications

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“…The apnoea may be treated with gentle tactile stimulation (Milner, 1999) (for example, gentle rubbing of the infant's back or the soles of the feet). A group of medications known as methylxanthines such as theophylline and caffeine 14 are used to treat apnoea of prematurity and have been shown to reduce apnoeic episodes by 60-90% in premature infants (Murat et al, 1981).…”

Section: Hypothermiamentioning

confidence: 99%

Stress experiences of parents with premature infants in a special care nursery

Lau

Morse

2003

Stress and Health

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This project is a controlled prospective longitudinal study of stress experiences of parents with premature infants born from 30-35 weeks gestation being cared for in a tertiary special care nursery (SCN). Sixty mothers and 59 fathers of premature infants and 60 mothers and fathers of term infants were recruited into the study. A range of repeated selfreports and biochemical markers of stress (cortisol and tribulin) were carried out on 5 measuring times through approximately a total of 24 weeks for parents of premature infants and 17 weeks for parents of term infants.Parents of premature infants reported higher stress levels than parents of term infants within the first week of infant's birth but had lower biochemical markers of stress. The stressors perceived by these parents in a SCN were appearance and behaviour of the infants and the delayed in performing the parental role. Parents used both emotion-and problemfocused coping strategies to deal with the stressful events.A follow-up telephone interview of these parents a year after the birth of their premature infant found that most parents expressed the experience as positive. A few parents were concerned over the neurodevelopmental and cognitive outcomes of their infants. Implications for clinical practice were discussed.

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Section: Hypothermiamentioning

confidence: 99%

Stress experiences of parents with premature infants in a special care nursery

Lau

Morse

2003

Stress and Health

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“…The beneficial effects of caffeine in these contexts are widely documented in both randomized and observational trials. [1][2][3] However, caffeine has other physiologic effects, including stimulating the central nervous and cardiovascular system, 4 enhancing catecholamine secretion, 4 and increasing basal metabolic rate. 4 At the pharmacologic level, caffeine acts by blocking adenosine receptors A1 and A2a, increasing cyclic 3, 5 adenosine monophosphate by inhibiting phosphodiesterase, and translocating intracellular calcium.…”

Section: Introductionmentioning

confidence: 99%

Acute hemodynamic effects of caffeine administration in premature infants

et al. 2008

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Objective: Administration of caffeine citrate (caffeine) has been a central component of the treatment of apnea of prematurity. However, given its multiple pharmacologic effects, caffeine might be expected to produce hemodynamic changes in heart rate, stroke volume, cardiac output and vascular resistance.Study Design: In this prospective observational study, we report the hemodynamic effects of intravenous caffeine administration in a population of premature infants who received caffeine to correct or prevent apnea of prematurity.Methods: Hemodynamic effects of caffeine were determined in 31 infants. Stroke volume was measured via echocardiogram, using velocity time integral at the aortic root diameter. Statistically univariate analyses were performed parametrically using paired t-test and nonparametrically (sign test). Multivariate linear regression models were used to identify subgroup covariate effects.Results: After intravenous caffeine, cardiac index increased in 31 of 31 trials, by an average of 14.6 ± 16.3% (s.d.); stroke volume increased in 24 of 31 trials, by 7.8±12.2%; heart rate increased in 28 of 31 trials by 7.7 ± 7.2 beats per min; and blood pressure increased in 25 of 31 trials, by 4.1±5.8 mm Hg (all P<0.001). Multivariate linear regression revealed no significant effect of dose, birth weight, gestational age or postnatal age.Conclusions: Intravenous caffeine consistently increases cardiac output and blood pressure in relatively stable premature infants, when given to treat or prevent apnea of prematurity. We speculate that there may be a role for caffeine in the hemodynamic treatment of hypotensive/ hypoperfused infants.

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“…Since the efficacy of caffeine in the treat ment of apnea in the premature neonate was demonstrated [1,2], it has been used rou tinely in intensive care units. More recently it has been proposed and used in near-miss sudden infant death syndrome [3] and also in Pierre Robin syndrome [4], The rate of caffeine elimination varies so much during the first months of life that individual drug monitoring is required to maintain plasma…”

Section: Introductionmentioning

confidence: 99%

Developmental Changes of Caffeine Elimination in Infancy

Pons

Carrier

et al. 1988

Dev Pharmacol Ther

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Five neonates (4 premature) and 16 infants (6 prematurely born), 15-588 days old, received caffeine as citrate salt for apnea. Plasma samples were collected 0, 2, 4, 6 h after a dose and before the next scheduled one. Patients 8 and 9 were serially studied. Caffeine plasma concentrations were determined using HPLC. The caffeine elimination half-life and clearance varied linearly with gestational age and exponentially with postnatal age, the plateau being reached during the second trimester of life. Dose regimen guidelines as a function of postnatal age were derived from individually calculated doses and dosing intervals in order to achieve, at steady state, a caffeine mean plasma concentration of 11 mg/1 with a minimum of 7.5 mg/l and a maximum of 14.5 mg/l. We suggest dosing intervals for infants before 1 month, 1-2 months, 2-4 months and after 4 months to be equal to 24, 12, 8 and 6 h, respectively. The individual recommended dose varies from 2 to 10 mg/kg (as caffeine base) making caffeine monitoring mandatory in infants.

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The efficacy of caffeine in the treatment of recurrent idiopathic apnea in premature infants

Cited by 66 publications

References 29 publications

Stress experiences of parents with premature infants in a special care nursery

Stress experiences of parents with premature infants in a special care nursery

Acute hemodynamic effects of caffeine administration in premature infants

Developmental Changes of Caffeine Elimination in Infancy

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