Cardiovascular effects of caffeine therapy in preterm infants.
Theophylline therapy increases left ventricular output in preterm infants by a combination of positive inotropic and chronotropic effects. The cardiovascular effects of caffeine were evaluated in 20 clinically stable preterm infants. Ten infants received intravenous caffeine citrate with a loading dose of 20 mg/kg and a maintenance dose of 5 mg/kg every 24 hours, and 10 infants were control subjects. Left ventricular output, stroke volume, and heart rate were measured by using a combination of two-dimensional and pulsed Doppler echocardiography and mean arterial blood pressure by oscillometry (Dinamap, Critikon, Division of McNeil Laboratories, Irvine, Calif) before the start and on days 1, 2, 3, and 7 of caffeine therapy and 7 days after discontinuation of therapy. Compared with controls, left ventricular output and stroke volume were significantly increased on days 1 to 7 of caffeine therapy. Caffeine led to an increase in the mean arterial blood pressure on the first 3 days of therapy, but the heart rate did not change. These data indicated that caffeine administration leads to a significant increase in left ventricular output in preterm infants and that this inotropic effect is accompanied by a pressor effect.
Department of Pediatrics, University of Southern California School of Medicine, Los Angeles 90059.
F J
FJ
Walther
R
R
Erickson
M E
ME
Sims
D001049:Apnea / Q000188:drug therapy; D001794:Blood Pressure / Q000187:drug effects*; D002110:Caffeine / Q000494:pharmacology* / Q000627:therapeutic use; D002302:Cardiac Output / Q000187:drug effects; D006321:Heart / Q000187:drug effects*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D007235:Infant, Premature, Diseases / Q000188:drug therapy; D013318:Stroke Volume / Q000187:drug effects; D015300:Ventilator Weaning
D002110:Caffeine