Effect of caffeine on superior mesenteric artery blood flow velocities in preterm neonates

• Published in: The journal of maternal-fetal & neonatal medicine 2019-02, Vol.32 (3), p.357-361
• Main Authors: Abdel Wahed, Mohamed A., Issa, Hanan M., Khafagy, Soha M., Abdel Raouf, Shaimaa M.
• Format: Article
• Language: English
• Subjects: Apnea of prematurity; Blood Flow Velocity - drug effects; Caffeine - pharmacology; Caffeine - therapeutic use; Citrates - pharmacology; Citrates - therapeutic use; duplex ultrasound; Female; Gestational Age; Hemodynamics - drug effects; Humans; Infant, Newborn; Infant, Premature - physiology; intestinal blood flow; Male; Mesenteric Artery, Superior - diagnostic imaging; Mesenteric Artery, Superior - drug effects; Mesenteric Artery, Superior - physiology; necrotizing enterocolitis; Pregnancy; Premature Birth - drug therapy; Premature Birth - physiopathology; Regional Blood Flow - drug effects; respiratory center; Ultrasonography, Doppler, Duplex
• ISSN: 1476-7058; 1476-4954
• DOI: 10.1080/14767058.2017.1378337

Objective: To investigate the effect of caffeine infusion on superior mesenteric artery (SMA) blood flow velocities (BFV) in preterm infants. Methods: Prospective observational study on 38 preterm neonates 28-33 +6 weeks gestation, who developed apnea on their first day of life, and caffeine citrate infusion was initiated at a loading dose of 20 mg/kg, followed by a maintenance dose of 5-10 mg/kg/day. Duplex ultrasound measurements of SMA BFV were recorded: peak systolic velocity (PSV), end diastolic velocity (EDV) and resistive index (RI), at 15 min before, 1-, 2- and 6-h after caffeine loading dose, and 2 h after two maintenance doses. Results: There was a significant reduction in PSV 1-h (p = .008), a significant decrease in EDV 1- and 2-h (p = .000 and p = .005, respectively) and a significant increase in RI 1- and 2-h (p = .003 and p = .005, respectively) following caffeine loading dose, as compared to values before caffeine infusion. No significant effect of caffeine maintenance doses on SMA BFV was observed (p > .05). Conclusion: Blood flow in SMA is significantly reduced after caffeine citrate infusion at a loading dose of 20 mg/kg. This effect continues for at least 2 h. Meanwhile, SMA BFV seems not affected by maintenance doses.