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Electrical activity of the diaphragm following a loading dose of caffeine citrate in ventilated preterm infants

Research output: Contribution to journalArticle

Emma E. Williams, Katie A. Hunt, Janathan Jeyakara, Raghavendra Subba-Rao, Theodore Dassios, Anne Greenough

Original languageEnglish
JournalPediatric Research
Early online date17 Oct 2019
Accepted/In press25 Sep 2019
E-pub ahead of print17 Oct 2019


King's Authors


Background: Administration of caffeine citrate can facilitate extubation. Our aim was to determine whether a loading dose of caffeine citrate given to ventilated, preterm infants affected the diaphragm electrical activity. Methods: Infants <34 weeks of gestational age were recruited if requiring mechanical ventilation and prescribed a loading dose of caffeine citrate. Surface electrodes recorded the electrical activity of the diaphragm (dEMG) before and after administration of intravenous caffeine citrate. The mean amplitude of the EMG (dEMG) trace and the mean area under the EMG curve (aEMGc) were calculated. Results: Thirty-two infants were assessed with a median gestational age of 29 (27–31) weeks. The dEMG amplitude increased, peaking at 25 min post administration (p = 0.006), and the increase in aEMGc (p = 0.004) peaked at 30 min; the differences were not significant after 60 min. At 20 min, there was an increase in minute volume (p = 0.034) and a reduction in the peak inspiratory pressure (p = 0.049). Conclusions: We have demonstrated a transient increase in both electrical activity of the diaphragm and respiratory function following an intravenous loading dose of caffeine citrate.

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