Abstract
Objective The aim of this study was to evaluate the effects of caffeine on cerebral oxygenation
in preterm infants.
Study Design This was a prospective study of infants with a gestational age (GA) of < 34 weeks
who were treated intravenously with a loading dose of 20 mg/kg caffeine citrate within
the first 48 hours of life. Regional cerebral oxygen saturation (rSO2C) and cerebral fractional tissue oxygen extraction (cFTOE) were measured using near-infrared
spectroscopy before administering caffeine (baseline), immediately after administering
caffeine, and 1, 2, 3, 4, 6, and 12 hours after dose completion; postdose values were
compared with the baseline values.
Results A total of 48 infants with a mean GA of 29.0 ± 1.9 weeks, birth weight of 1,286 ± 301 g,
and postnatal age of 32.4 ± 11.3 hours were included in the study. rSO2C significantly decreased from 81.3 to 76.7% soon after administering caffeine, to
77.1% at 1 hour, and to 77.8% at 2 hours with recovery at 3 hours postdose. rSO2C was 80.2% at 12 hours postdose. cFTOE increased correspondingly. Although rSO2C values were lower and cFTOE values were higher compared with the baseline values
at 3, 4, 6, and 12 hours after caffeine administration, this was not statistically
significant.
Conclusion A loading dose of caffeine temporarily reduces cerebral oxygenation and increases
cerebral tissue oxygen extraction in preterm infants. Most probably these changes
reflect a physiological phenomenon without any clinical importance to the cerebral
hemodynamics, as the reduction in cerebral oxygenation and increase in cerebral tissue
oxygen extraction remain well within acceptable range.
Keywords
caffeine - cerebral oxygenation - near-infrared spectroscopy - preterm infant - oxygen
saturation
