Effect of caffeine on preterm infants' cerebral cortical activity: an observational study

• Published in: The journal of maternal-fetal & neonatal medicine Vol. 28; no. 17; p. 2090
• Main Authors: Hassanein, Sahar M A, Gad, Ghada I, Ismail, Rania I H, Diab, Mohamed
• Format: Journal Article
• Language: English
• Published: England 22.11.2015
• Subjects: Apnea - prevention & control; Blood Pressure - drug effects; Caffeine - administration & dosage; Caffeine - therapeutic use; Cerebral Cortex - drug effects; Cerebral Cortex - growth & development; Cerebral Cortex - physiology; Electroencephalography - methods; Female; Gestational Age; Heart Rate - drug effects; Humans; Infant, Newborn; Infant, Premature - physiology; Infusions, Intravenous; Intensive Care, Neonatal; Length of Stay; Male; Oxygen - blood; Prospective Studies; Respiratory Physiological Phenomena - drug effects; Respiratory System - drug effects; Sleep - drug effects; Wakefulness - drug effects; cerebral cortical maturity; Amplitude-integrated electroencephalography; conventional electroencephalography; hospital stay; apnea of prematurity
• ISSN: 1476-4954
• DOI: 10.3109/14767058.2014.978757

Our first aim was to investigate the effects of caffeine on preterm infants' respiratory functions and brain cortical activity (conventional and amplitude-integrated electroencephalography (cEEG and aEEG)). Secondary aim was to study its long-term effects on respiratory system and electroencephalographic maturation by 36 weeks post-menstrual age. Prospective observational study on 33 consecutively admitted preterm infants less than 34-weeks-gestation. cEEG and aEEG, cardiopulmonary and sleep state were recorded in 20 preterm infants, before, during and 2-hours after intravenous (IV) caffeine (caffeine Group), and for 13 preterms (control group). Both groups were subjected to assessment of cerebral cortical maturation by cEEG and aEEG at 36-weeks post-menstrual age as an outcome measure. IV caffeine administration significantly increased heart rate (p = 0.000), mean arterial blood pressure (p = 0.000), capillary oxygen saturation (p = 0.003), arousability (p = 0.000) and aEEG continuity (p = 0.002) after half an hour. No clinical seizures were recorded and non-significant difference was found in electrographic seizures activity in cEEG. At 36-weeks post-conceptional age, NICU stay was significantly longer in controls (p = 0.022). aEEG score was significantly higher in caffeine group than the control group, (p = 0.000). Caffeine increases preterm infants' cerebral cortical activity during infusion and results in cerebral cortical maturation at 36weeks, without increase in seizure activity.