TY - JOUR
T1 - The Effect of Caffeine on Diaphragmatic Activity and Tidal Volume in Preterm Infants
AU - Kraaijenga, Juliette V.
AU - Hutten, Gerard J.
AU - de Jongh, Frans H.
AU - van Kaam, Anton H.
PY - 2015
Y1 - 2015
N2 - Objective To determine the effect of caffeine on diaphragmatic activity, tidal volume (V-t), and end-expiratory lung volume (EELV) in preterm infants. Study design Using transcutaneous electromyography of the diaphragm (dEMG), we measured diaphragmatic activity from 30 minutes before (baseline) to 3 hours after administration of an intravenous caffeine-base loading dose in 30 spontaneously breathing preterm infants (mean gestational age, 29.1 +/- 1.3 weeks), most of whom were on noninvasive respiratory support. Diaphragmatic activity was expressed as the percentage change in dEMG amplitude, area under the curve, respiratory rate, and inspiratory and expiratory times. Using respiratory inductive plethysmography, we measured changes in Vt and EELV from baseline. These outcome variables were calculated at 8 fixed time points after caffeine administration (5, 15, 30, 60, 90, 120, 150, and 180 minutes) and compared with baseline. Results Caffeine administration resulted in rapid (within 5 minutes) increases in dEMG amplitude (median, 43%; IQR, 24%-63%; P <.001) and area under the curve (median, 28%; IQR, 14%-48%; P <.001). Vt also increased by a median of 30% (IQR, 7%-48%), and this change was significantly correlated with the change in dEMG amplitude (r = 0.67; P <.001). These effects were relatively stable until 120 minutes after caffeine administration. Caffeine did not consistently impact EELV, respiratory rate, or inspiratory and expiratory times. Conclusion Caffeine treatment results in a rapid and sustained increase in diaphragmatic activity and Vt in preterm infants
AB - Objective To determine the effect of caffeine on diaphragmatic activity, tidal volume (V-t), and end-expiratory lung volume (EELV) in preterm infants. Study design Using transcutaneous electromyography of the diaphragm (dEMG), we measured diaphragmatic activity from 30 minutes before (baseline) to 3 hours after administration of an intravenous caffeine-base loading dose in 30 spontaneously breathing preterm infants (mean gestational age, 29.1 +/- 1.3 weeks), most of whom were on noninvasive respiratory support. Diaphragmatic activity was expressed as the percentage change in dEMG amplitude, area under the curve, respiratory rate, and inspiratory and expiratory times. Using respiratory inductive plethysmography, we measured changes in Vt and EELV from baseline. These outcome variables were calculated at 8 fixed time points after caffeine administration (5, 15, 30, 60, 90, 120, 150, and 180 minutes) and compared with baseline. Results Caffeine administration resulted in rapid (within 5 minutes) increases in dEMG amplitude (median, 43%; IQR, 24%-63%; P <.001) and area under the curve (median, 28%; IQR, 14%-48%; P <.001). Vt also increased by a median of 30% (IQR, 7%-48%), and this change was significantly correlated with the change in dEMG amplitude (r = 0.67; P <.001). These effects were relatively stable until 120 minutes after caffeine administration. Caffeine did not consistently impact EELV, respiratory rate, or inspiratory and expiratory times. Conclusion Caffeine treatment results in a rapid and sustained increase in diaphragmatic activity and Vt in preterm infants
U2 - https://doi.org/10.1016/j.jpeds.2015.04.040
DO - https://doi.org/10.1016/j.jpeds.2015.04.040
M3 - Article
C2 - 25982138
SN - 0022-3476
VL - 167
SP - 70
EP - 75
JO - Journal of pediatrics
JF - Journal of pediatrics
IS - 1
ER -