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العنوان
Effect of Caffeine Administration on
Superior Mesenteric Artery Blood Flow
Velocities in Preterm Infants\
المؤلف
Abdel-Raouf, Shaimaa Mahmoud.
هيئة الاعداد
باحث / Shaimaa Mahmoud Abdel-Raouf
مشرف / Mohamed Ashraf Abdul Wahed
مشرف / Hanan Mohamed Issa
مناقش / Soha Mohamed Khafagy
تاريخ النشر
2014.
عدد الصفحات
200p. :
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
طب الأطفال ، الفترة المحيطة بالولادة وصحة الطفل
تاريخ الإجازة
1/1/2014
مكان الإجازة
جامعة عين شمس - كلية الطب - طب الاطفال
الفهرس
Only 14 pages are availabe for public view

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Abstract

SUMMARY AND CONCLUSION
ecrotizing enterocolitis is one of the worst medical
problems occurring in neonates. It is more common in
premature babies, with mortality rate more than 50% in very
low birth weight. The etiology of NEC is multifactorial, and the
most important risk factors are prematurity, hypoxia and/or
intestinal ischemia. Many medications have been implicated as
a risk factor in NEC such as Xanthine derivatives, such as
theophylline, aminophylline and caffeine.
Caffeine is now one of the most commonly prescribed
drugs in the NICU, and has appropriately been described as a
”silver bullet” in neonatology. When the Food and Drug
Administration approved caffeine citrate (Cafcit) for the
treatment of apnoea of prematurity, a warning was included in
the label about the possible association between the use of
methylxanthines and the development of necrotizing
enterocolitis.
Pulsed Doppler US is used to measure blood-flow
velocity in the superior mesenteric artery for investigating the
maturation of intestinal circulation and the pathogenesis or
pathophysiology of gastrointestinal diseases in newborn infants
and we used it to evaluate the effect of caffeine citrate on the
SMA BFV.
N
Summary and Conclusion 􀀉
137
Our study included 38 preterm, less than 34 weeks with
no significant PDA, major congenital anomalies or perinatal
asphyxia.
They were all subjected to the following:
1. Full history taking
2. Thorough clinical examination including
3. Recorded APGAR score at 1st&5th minutes
4. CBC&CRP
5. Abdominal Doppler ultrasound
- Superior mesenteric artery peak systolic and end
diastolic velocities measured using Doppler
ultrasound.blood pressure & heart rate
- The first measurements were taken 15 min before
caffeine loading dose administration.
- These measurements repeated at 60, 120 and 360
min after caffeine loading dose administration, and
were taken 120 min after the caffeine maintenance
dose administration for 2 successive days.
6. All infants were examined for signs of necrotizing
enterocolitis for at least 72 h after completion of SMA
BFV measurement.
Twenty two preterm completed the study whereas, two
(5.2%) of the studied neonates developed NEC within three
Summary and Conclusion 􀀉
138
days following the loading dose of the caffeine citrate, four
(10.5%) were transmitted to a different NICU, six (15%) died
before completing the full caffeine citrate regimen and four
were excluded from the study due to their unstable general
condition.
We found that caffeine citrate had variable hemodynamic
effects of the SMA that were different at each time of
measurement. By 2 hours of giving LD of caffeine citrate there
was significant decrease in PSV and EDV with significant
increase of RI in comparison to these measures before the
loading dose of each baby.
At 6 hours, these measures were nearly normalized in
relation to the pre loading measures.
All the previous measures, after starting maintenance
dose, did not show any significant difference in relation to the
pre loading measures.
After discontinuation there was non significant increase
in PSV, EDV and RI in comparison to the pre loading
measures.
We found no significant change in mean BP (But there
was mild increase) except after discontinuation of caffeine
when there was a significant increase in relation to pre loading
period.
Summary and Conclusion 􀀉
139
We also, did not find any significant variation in HR of
our babies (but there was a mild increase) all over the study.
There were only 2 babies that developed NEC of within
the first 3 days following the loading dose.
As a conclusion. Our data show that the loading dose of
caffeine citrate to preterm neonates causes a prolonged and
significant reduction in SMA BFV for 1-2 hours which had
returned to baseline within 6 hours. Whether this observation is
of clinical importance is unclear, but it is a finding of which
clinicians should be aware and one which deserves further
study.