The metabolic effects of caffeine in the newborn infant.
We studied the effects of intravenous administration of 20 mg/kg caffeine citrate on glucose homeostasis, cardiorespiratory status, and urinary excretion of catecholamines and electrolytes in 12 premature infants with recurrent apnea. Six infants received intravenous dextrose (5% or 10% in 0.225% saline) during the study, and six were fed formula every 3-4 hours. In the intravenously fed infants, the plasma glucose concentration postcaffeine did not vary significantly from the precaffeine level of 73 +/- 3.2 mg/dl (mean +/- SEM) at 0.5, 1, and 1.5 hours. However, in the formula-fed infants, there was a consistent fall in plasma glucose levels after caffeine administration. This decrease from a precaffeine level of 99 +/- 12 mg/dl (mean +/- SEM) approached statistical significance at 0.5 hours (P = 0.07), and was significantly lower at 1 and 1.5 hours (P less than 0.02). In five infants, cardiorespiratory status and urinary excretion of catecholamines and electrolytes were evaluated for 12-hour periods before and after caffeine administration. There was a significant reduction in the number of apneic episodes following caffeine administration; however, caffeine did not appear to affect mean heart rate or urinary excretion of sodium, potassium, epinephrine, norepinephrine, or dopamine. Our data suggest that the effects of caffeine on glucose homeostasis may vary with the nature and/or route of substrate administration.
D001049:Apnea / Q000378:metabolism; D001786:Blood Glucose / Q000378:metabolism; D002110:Caffeine / Q000494:pharmacology*; D002395:Catecholamines / Q000378:metabolism; D004573:Electrolytes / Q000378:metabolism; D006339:Heart Rate / Q000187:drug effects; D006706:Homeostasis / Q000187:drug effects; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000378:metabolism; D010288:Parenteral Nutrition
D001786:Blood Glucose; D002395:Catecholamines; D004573:Electrolytes; D002110:Caffeine