Abstract
Objectives: We hypothesized that caffeine would be associated with a transient reduction in the right-to-left shunt and VAQ. We aimed to explore the temporal effects of caffeine on right-to-left shunt, ventilation perfusion ratio (VAQ) and shift of the oxyhaemoglobin dissociation curve (ODC) in premature ventilated infants.
Methods: Retrospective cohort study at a tertiary neonatal unit of infants born at less than 31 weeks of gestation that were mechanically ventilated on day three of life. The non-invasive method of the ODC was used to determine the right-to-left shunt, VAQ and shift before and at one hour, four hours and twenty hours after a maintenance dose of caffeine citrate.
Results: Twenty-one infants were included with a median (range) gestational age of 27 (23.7-30.7) weeks. The median shunt percentage was significantly reduced, compared to baseline at one hour (8 (range: 7-9) % versus 4 (range: 0-6) %, p=0.042) and four hours post caffeine administration (8 (range: 7-9) % versus 0 (range: 0-3) %, p=0.042), but the VA/Q and the right shift of the ODC did not differ significantly between these time points. At twenty hours, there were no significant differences between these indices compared to baseline values.
Conclusion: Caffeine led to a transient decrease in intrapulmonary shunt from one to four hours after administration and this may be due to its diuretic action.
Methods: Retrospective cohort study at a tertiary neonatal unit of infants born at less than 31 weeks of gestation that were mechanically ventilated on day three of life. The non-invasive method of the ODC was used to determine the right-to-left shunt, VAQ and shift before and at one hour, four hours and twenty hours after a maintenance dose of caffeine citrate.
Results: Twenty-one infants were included with a median (range) gestational age of 27 (23.7-30.7) weeks. The median shunt percentage was significantly reduced, compared to baseline at one hour (8 (range: 7-9) % versus 4 (range: 0-6) %, p=0.042) and four hours post caffeine administration (8 (range: 7-9) % versus 0 (range: 0-3) %, p=0.042), but the VA/Q and the right shift of the ODC did not differ significantly between these time points. At twenty hours, there were no significant differences between these indices compared to baseline values.
Conclusion: Caffeine led to a transient decrease in intrapulmonary shunt from one to four hours after administration and this may be due to its diuretic action.
| Original language | English |
|---|---|
| Journal | Journal of Perinatal Medicine |
| Publication status | Published - 2024 |