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Published on: September 6, 2017
Effect of caffeine on preterm infants' cerebral cortical activity: an observational study
Sahar M A Hassanein1, Ghada I Gad1, Rania I H Ismail1
1a Department of Pediatrics, Faculty of Medicine , Ain Shams University , Cairo , Egypt and.
Insights
Caffeine administration in preterm infants improved respiratory function and brain activity. This treatment also promoted cerebral cortical maturation by 36 weeks post-menstrual age without increasing seizure risk.
Area of Science:
- Neonatal Medicine
- Developmental Neuroscience
- Pediatric Pharmacology
Background:
- Preterm infants often experience respiratory and neurological challenges.
- Caffeine is commonly used in neonatal intensive care units (NICUs).
- Understanding caffeine's precise effects on preterm infants' brain development is crucial.
Purpose of the Study:
- To assess the immediate effects of intravenous caffeine on respiratory function and brain activity in preterm infants.
- To evaluate the long-term impact of caffeine on electroencephalographic maturation by 36 weeks post-menstrual age.
Main Methods:
- A prospective observational study involving 33 preterm infants (<34 weeks gestation).
- Conventional and amplitude-integrated electroencephalography (cEEG and aEEG), cardiopulmonary, and sleep state monitoring were performed.
- Infants received intravenous caffeine (caffeine group) or served as controls, with assessments at baseline and post-infusion, and maturation assessed at 36 weeks post-menstrual age.
Main Results:
- Caffeine significantly enhanced heart rate, mean arterial blood pressure, oxygen saturation, arousability, and aEEG continuity shortly after administration.
- No clinical or significant electrographic seizures were observed.
- Infants receiving caffeine showed a significantly higher aEEG score at 36 weeks post-menstrual age, indicating improved cerebral cortical maturation, and had shorter NICU stays compared to controls.
Conclusions:
- Intravenous caffeine positively impacts preterm infants' respiratory and cerebral cortical activity.
- Caffeine administration leads to enhanced cerebral cortical maturation by 36 weeks post-menstrual age.
- The study supports caffeine's role in improving neurological outcomes in preterm infants without increasing seizure activity.
Objective:
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.
Methods:
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.
Results:
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).
Conclusions:
Caffeine increases preterm infants' cerebral cortical activity during infusion and results in cerebral cortical maturation at 36weeks, without increase in seizure activity.
