Caffeine is a respiratory stimulant without effect on sleep in the short-term in late-preterm infants

Abstract Background Caffeine is widely used in preterm infants for apnea control. It has no effect on sleep in the only existing polysomnographic study including ten preterm infants Behavioral and polygraphic studies have conflicting results. Methods We studied 21 late-preterm infants at a median gestational age of 36 weeks. Polysomnography was performed twice, at baseline on day 1 and on the day after the onset of caffeine treatment (20 mg/kg loading and 5 mg/kg morning maintenance dose). Results Caffeine acted short term as a breathing stimulant with reduction of apneas, improved baseline SpO2 (p < 0.001), and decreased 95 percentile of end-tidal carbon dioxide level (p < 0.01). It also increased arousal frequency to SpO2 desaturations of more than 5% (p < 0.001). Caffeine did not affect sleep stage distribution, sleep efficiency, frequency of sleep stage transitions, appearance of REM periods, or the high number of spontaneous arousals. The median spontaneous arousal count was 18 per hour at baseline, and 16 per hour during caffeine treatment (p = 0.88). Conclusions In late-preterm infants, caffeine has a clear short-term respiratory stimulant effect, and it increases the arousal frequency to hypoxia. However, caffeine does not appear to act as a central nervous system stimulant, and it has no acute effect on sleep quality. Impact Effects of caffeine on sleep in preterm infants has previously been investigated with only one full polysomnographic study including ten preterm infants. The study showed no effect. The current study shows that caffeine acts short term as a respiratory stimulant and increases arousal frequency to hypoxia. Although a potent central nervous system (CNS) stimulant in adults, caffeine does not seem to have similar acute CNS effect in late-preterm infants. The onset of caffeine treatment has no short-term effect on sleep stage distribution, sleep efficiency, frequency of sleep stage transitions, appearance of REM periods, or the high number of spontaneous arousals.

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Late Preterm Infants at Risk for Short-Term and Long Term Morbidity and Mortality

Neonatology ◽

10.1007/978-3-319-18159-2_159-1 ◽

2017 ◽

pp. 1-12

Author(s):

Avroy A. Fanaroff

Keyword(s):

At Risk ◽

Preterm Infants ◽

Late Preterm ◽

Morbidity And Mortality ◽

Short Term ◽

Late Preterm Infants

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Short-term Morbidities in Moderate and Late Preterm Infants

Klinische Pädiatrie ◽

10.1055/s-0033-1355394 ◽

2013 ◽

Vol 226 (04) ◽

pp. 216-220 ◽

Cited By ~ 1

Author(s):

A. Scheuchenegger ◽

E. Lechner ◽

G. Wiesinger-Eidenberger ◽

M. Weissensteiner ◽

O. Wagner ◽

...

Keyword(s):

Preterm Infants ◽

Late Preterm ◽

Short Term ◽

Late Preterm Infants

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Short-Term Outcomes following Standardized Admission of Late Preterm Infants to Family-Centered Care

American Journal of Perinatology ◽

10.1055/s-0039-1694981 ◽

2019 ◽

Author(s):

Jonathan Reiss ◽

Pavan S. Upadhyayula ◽

Hyeri You ◽

Ronghui Xu ◽

Lisa M. Stellwagen

Keyword(s):

Preterm Infants ◽

Neonatal Intensive Care ◽

Transitions Of Care ◽

Late Preterm ◽

Family Centered Care ◽

Short Term ◽

Late Preterm Infants ◽

Car Seat ◽

Centered Care ◽

Family Centered

Abstract Objective The study compares the short-term outcomes of late preterm infants (LPI) at an academic center in San Diego, California after a change in protocol that eliminated a previously mandatory 12-hour neonatal intensive care unit (NICU) observation period after birth. Study Design This is a retrospective observational study examining all LPI born with gestational age 35 to 366/7 weeks between October 1, 2016 and October 31, 2017. A total of 189 infants were included in the review. Short-term outcomes were analyzed before and after the protocol change. Results Transfers to the NICU from family-centered care (FCC) were considerably higher (23.2%) following the protocol change, compared to before (8.2%). More infants were transferred to the NICU for failed car seat tests postprotocol compared to preprotocol. Length of stay before the protocol change was 5.13 days compared to 4.80 days after. Conclusion LPI are vulnerable to morbidities after delivery and through discharge. We found an increase in failed car seat tests in LPI cared for in FCC after elimination of a mandatory NICU observation after birth. The transitions of care from delivery to discharge are key checkpoints in minimizing complications.

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Late Preterm Infants at Risk for Short-Term and Long-Term Morbidity and Mortality

Neonatology ◽

10.1007/978-3-319-29489-6_159 ◽

2018 ◽

pp. 171-182

Author(s):

Avroy A. Fanaroff

Keyword(s):

At Risk ◽

Preterm Infants ◽

Late Preterm ◽

Morbidity And Mortality ◽

Short Term ◽

Late Preterm Infants

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Short-term respiratory outcomes in late preterm infants

Italian Journal of Pediatrics ◽

10.1186/1824-7288-40-52 ◽

2014 ◽

Vol 40 (1) ◽

pp. 52 ◽

Cited By ~ 17

Author(s):

Miria Natile ◽

Maria Ventura ◽

Marco Colombo ◽

Davide Bernasconi ◽

Anna Locatelli ◽

...

Keyword(s):

Preterm Infants ◽

Late Preterm ◽

Short Term ◽

Late Preterm Infants ◽

Respiratory Outcomes

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Late Preterm Infants at Risk for Short-Term and Long-Term Morbidity and Mortality

Neonatology ◽

10.1007/978-88-470-1405-3_14 ◽

2012 ◽

pp. 94-101

Author(s):

Avroy A. Fanaroff

Keyword(s):

At Risk ◽

Preterm Infants ◽

Late Preterm ◽

Morbidity And Mortality ◽

Short Term ◽

Late Preterm Infants

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Prediction Effect of Amplitude-Integrated EEG on the Brain Damage and Long-Term Nervous System Development of Late Preterm Infants

Journal of Healthcare Engineering ◽

10.1155/2021/4041082 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Sehua Qu ◽

Lianqiang Shan ◽

Zhen Zhang ◽

Wansheng Peng ◽

Yun Chen ◽

...

Keyword(s):

Nervous System ◽

Brain Damage ◽

Preterm Infants ◽

System Development ◽

Nervous System Development ◽

Late Preterm ◽

Clinical Prediction ◽

Late Preterm Infants ◽

The Brain

In order to explore the prediction effect of amplitude-integrated EEG on the brain damage and long-term nervous system development of late preterm infants, this paper uses the hospital’s late preterm infants as the research object and analyzes the prediction effect of amplitude-integrated EEG on the brain damage and long-term nervous system development of late preterm infants through controlled trials. Among them, the test group used amplitude-integrated EEG for prediction analysis, and the control group used traditional clinical prediction methods. Furthermore, the real-time monitoring and short-term prediction effects of amplitude-integrated EEG on brain damage in late preterm babies and the prediction impact on long-term nervous system development are evaluated in this study. It incorporates statistical techniques to evaluate the findings statistically. In addition, a nonparametric rank-sum test is used in this work, and a chi-square test is used to compare enumeration data across groups. Through experimental research, it can be seen that the amplitude-integrated EEG has a pronounced prediction effect on the brain damage and long-term nervous system development of late preterm infants, and the effect is higher than that of the traditional clinical prediction methods.

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