title: Effect of caffeine on preterm infants' cerebral cortical activity: an observational study.
abstract: OBJECTIVE
  Our first aim was to investigate the effects of caffeine on preterm infants' respiratory functions and brain cortical activity (conventional and amplitude-integrated electroencephalography (cEEG and aEEG)). Secondary aim was to study its long-term effects on respiratory system and electroencephalographic maturation by 36 weeks post-menstrual age.
  
  
  METHODS
  Prospective observational study on 33 consecutively admitted preterm infants less than 34-weeks-gestation. cEEG and aEEG, cardiopulmonary and sleep state were recorded in 20 preterm infants, before, during and 2-hours after intravenous (IV) caffeine (caffeine Group), and for 13 preterms (control group). Both groups were subjected to assessment of cerebral cortical maturation by cEEG and aEEG at 36-weeks post-menstrual age as an outcome measure.
  
  
  RESULTS
  IV caffeine administration significantly increased heart rate (p = 0.000), mean arterial blood pressure (p = 0.000), capillary oxygen saturation (p = 0.003), arousability (p = 0.000) and aEEG continuity (p = 0.002) after half an hour. No clinical seizures were recorded and non-significant difference was found in electrographic seizures activity in cEEG. At 36-weeks post-conceptional age, NICU stay was significantly longer in controls (p = 0.022). aEEG score was significantly higher in caffeine group than the control group, (p = 0.000).
  
  
  CONCLUSIONS
  Caffeine increases preterm infants' cerebral cortical activity during infusion and results in cerebral cortical maturation at 36weeks, without increase in seizure activity.
authors.affiliation: a Department of Pediatrics, Faculty of Medicine , Ain Shams University , Cairo , Egypt and.
authors.forename: Sahar M A
authors.initials: SM
authors.lastname: Hassanein
authors.affiliation: a Department of Pediatrics, Faculty of Medicine , Ain Shams University , Cairo , Egypt and.
authors.forename: Ghada I
authors.initials: GI
authors.lastname: Gad
authors.affiliation: a Department of Pediatrics, Faculty of Medicine , Ain Shams University , Cairo , Egypt and.
authors.forename: Rania I H
authors.initials: RI
authors.lastname: Ismail
authors.affiliation: b Visitor NICU Resident, Ain Shams University , Cairo , Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Diab
mesh_terms: D001049:Apnea / Q000517:prevention & control; D001794:Blood Pressure / Q000187:drug effects; D002110:Caffeine / Q000008:administration & dosage / Q000627:therapeutic use*; D002540:Cerebral Cortex / Q000187:drug effects* / Q000254:growth & development / Q000502:physiology; D004569:Electroencephalography / Q000379:methods; D005260:Female; D005865:Gestational Age; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D007262:Infusions, Intravenous; D015931:Intensive Care, Neonatal; D007902:Length of Stay; D008297:Male; D010100:Oxygen / Q000097:blood; D011446:Prospective Studies; D012143:Respiratory Physiological Phenomena / Q000187:drug effects; D012137:Respiratory System / Q000187:drug effects; D012890:Sleep / Q000187:drug effects; D014851:Wakefulness / Q000187:drug effects
chemical_list: D002110:Caffeine; D010100:Oxygen
keywords: Amplitude-integrated electroencephalography; apnea of prematurity; cerebral cortical maturity; conventional electroencephalography; hospital stay