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J Perinatol. 2017 Oct;37(10):1135-1140. doi: 10.1038/jp.2017.82. Epub 2017 Jul 27.

Caffeine decreases intermittent hypoxia in preterm infants nearing term-equivalent age.

Author information

1
Department of Pediatrics, Uniformed Services University of Health Sciences, Bethesda, MD, USA.
2
Department of Newborn Medicine and Respiratory Diseases, Boston Children's Hospital, Boston, MA, USA.
3
Department of Pediatrics, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.
4
Department of Pediatrics, Boston University School of Medicine, Boston, MA, USA.
5
Slone Epidemiology Center at Boston University, Boston, MA, USA.
6
Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA.
7
Department of Pediatrics, University of Texas Health Sciences Center, Children's Memorial Hermann Hospital, Houston, TX, USA.
8
Department of Pediatrics, University of Arkansas for Medical Sciences and Arkansas Children's Research Institute, Little Rock, AR, USA.
9
American SIDS Institute, Naples, FL, USA.

Abstract

OBJECTIVE:

To determine whether intermittent hypoxia (IH) persisting after 36 weeks postmenstrual age (PMA) can be attenuated using caffeine doses sufficient to maintain caffeine concentrations >20 μg ml-1.

STUDY DESIGN:

Twenty-seven infants born <32 weeks were started on caffeine citrate at 10 mg kg-1 day-1 when clinical caffeine was discontinued. At 36 weeks PMA, the dose was increased to 14 or 20 mg kg-1 day-1 divided twice a day (BID) to compensate for progressively increasing caffeine metabolism. Caffeine concentrations were measured weekly. The extent of IH derived from continuous pulse oximetry was compared to data from 53 control infants.

RESULT:

The mean (s.d.) gestational age of enrolled infants was 27.9±2 weeks. Median caffeine levels were >20 μg ml-1 on study caffeine doses. IH was significantly attenuated through 38 weeks PMA compared with the control group.

CONCLUSION:

Caffeine doses of 14 to 20 mg kg-1 day-1 were sufficient to maintain caffeine concentrations >20 μg ml-1 and reduce IH in preterm infants at 36 to 38 weeks PMA.

PMID:
28749480
DOI:
10.1038/jp.2017.82
[Indexed for MEDLINE]

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