Haemodynamic effects of prenatal caffeine on the cardiovascular transition in ventilated preterm lambs

被引:3
作者
Binder-Heschl, Corinna [1 ,2 ]
Crossley, Kelly [2 ]
te Pas, Arjan [3 ]
Polglase, Graeme [2 ]
Blank, Douglas [2 ,4 ]
Zahra, Valerie [2 ]
Moxham, Alison [2 ]
Rodgers, Karyn [2 ]
Hooper, Stuart [2 ]
机构
[1] Med Univ Graz, Graz, Austria
[2] Hudson Inst Med Res, Ritchie Ctr, Clayton, Vic, Australia
[3] Leiden Univ, Dept Pediat, Med Ctr, Leiden, Netherlands
[4] Royal Womens Hosp, Newborn Res Ctr, Melbourne, Vic, Australia
来源
PLOS ONE | 2018年 / 13卷 / 07期
基金
奥地利科学基金会;
关键词
RANDOMIZED CONTROLLED-TRIAL; BLOOD-FLOW-VELOCITY; PREMATURE-INFANTS; ADENOSINE RECEPTORS; CLINICAL-OUTCOMES; DUCTUS-ARTERIOSUS; DOSE CAFFEINE; THERAPY; APNEA; BIRTH;
D O I
10.1371/journal.pone.0200572
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background Caffeine is routinely given to preterm infants hours after birth to treat apnea of prematurity. In view of it's success, earlier administration in the delivery room is being considered, but little is known about how caffeine may effect the cardiovascular changes during the fetal to neonatal transition. Our aim was to determine the effect of prenatal caffeine administration on haemodynamic parameters in ventilated preterm lambs immediately after birth. Methods Catheters (carotid artery and jugular vein) and ultrasonic flow probes (pulmonary artery and carotid artery) were implanted in preterm lambs (similar to 126 +/- 2 days of gestation; term is 147 days), immediately before delivery by caesarean section. Before the cord was clamped, lambs were intubated and a caffeine (10mg/kg caffeine-base; n = 9) or saline (n = 5) infusion was given intravenously to the ewe and lamb over a 15-minute period. Two minutes after clamping the cord, ventilation commenced with a sustained inflation (35 cm H2O for 30 seconds) followed by ventilation for 30 minutes (target tidal volume of 6-8ml/kg). Results Blood gas parameters and rectal body temperature were not different between the two groups. Changes in pulmonary blood flow (PBF) and carotid blood flow (CBF) did not differ significantly between groups. PBF increased significantly after ventilation onset in both groups (caffeine p = 0.022, saline p <0.001) and remained elevated thereafter. CBF did not increase but decreased after SI in the caffeine group. Blood pressure, heart rate, and peripheral oxygen saturation did not differ between groups at any stage of the study. Conclusion Prenatal caffeine infusion had no significant effect on acute haemodynamic parameters in ventilated preterm lambs during the cardiorespiratory transition.
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页数:10
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