Brain hemodynamic changes in preterm infants after maintenance dose caffeine and aminophylline treatment.
OBJECTIVE
To investigate the acute effects of low-dose caffeine and aminophylline on cerebral blood flow in preterm infants, using both near-infrared spectroscopy (NIRS) and cerebral Doppler ultrasonography.


METHODS
Preterm infants with a gestational age of <32 weeks and birth weight of <1,500 g were randomized to receive either caffeine or aminophylline treatment for apnea of prematurity. The study period went from 30 min before to 60 min after the administration of the maintenance dose of pure caffeine (2.5 mg/kg once a day) or aminophylline (1.25 mg/kg twice a day). NIRS was used to measure changes in oxygenated hemoglobin (O(2)Hb), deoxygenated hemoglobin (HHb), oxidized-reduced cytochrome aa3 (CtOx), and mean cerebral oxygen saturation (SmO(2) = O(2)Hb/total Hb). Changes in cerebral blood volume (DeltaCBV) after caffeine or aminophylline administration were calculated. Cerebral blood flow velocity (CBV) in the pericallosal artery was evaluated by cerebral Doppler ultrasounds.


RESULTS
Data collected by NIRS and cerebral Doppler ultrasounds did not show significant differences before and after caffeine treatment. We observed a significant increase in O(2)Hb and HHb concentration and in CBV at 30 min after the infusion of aminophylline, which tended to return to baseline at the end of the study period.


CONCLUSIONS
Caffeine does not significantly affect brain hemodynamics, while aminophylline induces a significant transient increase in O(2)Hb and HHb concentration and CBV.
Dani
C
C
Division of Neonatology, Careggi University Hospital, Florence, Italy. cdani@unifi.it
Bertini
G
G
Reali
M F
MF
Tronchin
M
M
Wiechmann
L
L
Martelli
E
E
Rubaltelli
F F
FF
D000628:Aminophylline / Q000008:administration & dosage / Q000009:adverse effects*; D001049:Apnea / Q000188:drug therapy; D001724:Birth Weight; D001783:Blood Flow Velocity / Q000187:drug effects; D001810:Blood Volume / Q000187:drug effects; D002110:Caffeine / Q000008:administration & dosage / Q000009:adverse effects*; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000009:adverse effects*; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D003576:Electron Transport Complex IV / Q000097:blood; D005865:Gestational Age; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D007235:Infant, Premature, Diseases / Q000188:drug therapy; D010100:Oxygen / Q000097:blood; D010108:Oxyhemoglobins / Q000032:analysis; D018608:Ultrasonography, Doppler
D000697:Central Nervous System Stimulants; D006454:Hemoglobins; D010108:Oxyhemoglobins; D000628:Aminophylline; D002110:Caffeine; C100003:deoxyhemoglobin; D003576:Electron Transport Complex IV; D010100:Oxygen