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Caffeine and Clinical Outcomes in Premature Neonates

Caffeine is the most widely used drug by both adults and children worldwide due to its ability to promote alertness and elevate moods. It is effective in the management of apnea of prematurity in premature infants. Caffeine for apnea of prematurity reduces the incidence of bronchopulmonary dysplasia...

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Autores principales: Kumar, Vasantha H.S., Lipshultz, Steven E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6915633/
https://www.ncbi.nlm.nih.gov/pubmed/31653108
http://dx.doi.org/10.3390/children6110118
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author Kumar, Vasantha H.S.
Lipshultz, Steven E.
author_facet Kumar, Vasantha H.S.
Lipshultz, Steven E.
author_sort Kumar, Vasantha H.S.
collection PubMed
description Caffeine is the most widely used drug by both adults and children worldwide due to its ability to promote alertness and elevate moods. It is effective in the management of apnea of prematurity in premature infants. Caffeine for apnea of prematurity reduces the incidence of bronchopulmonary dysplasia in very-low-birth-weight infants and improves survival without neurodevelopmental disability at 18–21 months. Follow-up studies of the infants in the Caffeine for Apnea of Prematurity trial highlight the long-term safety of caffeine in these infants, especially relating to motor, behavioral, and intelligence skills. However, in animal models, exposure to caffeine during pregnancy and lactation adversely affects neuronal development and adult behavior of their offspring. Prenatal caffeine predisposes to intrauterine growth restriction and small growth for gestational age at birth. However, in-utero exposure to caffeine is also associated with excess growth, obesity, and cardio-metabolic changes in children. Caffeine therapy is a significant advance in newborn care, conferring immediate benefits in preterm neonates. Studies should help define the appropriate therapeutic window for caffeine treatment along with with the mechanisms relating to its beneficial effects on the brain and the lung. The long-term consequences of caffeine in adults born preterm are being studied and may depend on the ability of caffeine to modulate both the expression and the maturation of adenosine receptors in infants treated with caffeine.
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spelling pubmed-69156332019-12-24 Caffeine and Clinical Outcomes in Premature Neonates Kumar, Vasantha H.S. Lipshultz, Steven E. Children (Basel) Review Caffeine is the most widely used drug by both adults and children worldwide due to its ability to promote alertness and elevate moods. It is effective in the management of apnea of prematurity in premature infants. Caffeine for apnea of prematurity reduces the incidence of bronchopulmonary dysplasia in very-low-birth-weight infants and improves survival without neurodevelopmental disability at 18–21 months. Follow-up studies of the infants in the Caffeine for Apnea of Prematurity trial highlight the long-term safety of caffeine in these infants, especially relating to motor, behavioral, and intelligence skills. However, in animal models, exposure to caffeine during pregnancy and lactation adversely affects neuronal development and adult behavior of their offspring. Prenatal caffeine predisposes to intrauterine growth restriction and small growth for gestational age at birth. However, in-utero exposure to caffeine is also associated with excess growth, obesity, and cardio-metabolic changes in children. Caffeine therapy is a significant advance in newborn care, conferring immediate benefits in preterm neonates. Studies should help define the appropriate therapeutic window for caffeine treatment along with with the mechanisms relating to its beneficial effects on the brain and the lung. The long-term consequences of caffeine in adults born preterm are being studied and may depend on the ability of caffeine to modulate both the expression and the maturation of adenosine receptors in infants treated with caffeine. MDPI 2019-10-24 /pmc/articles/PMC6915633/ /pubmed/31653108 http://dx.doi.org/10.3390/children6110118 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Kumar, Vasantha H.S.
Lipshultz, Steven E.
Caffeine and Clinical Outcomes in Premature Neonates
title Caffeine and Clinical Outcomes in Premature Neonates
title_full Caffeine and Clinical Outcomes in Premature Neonates
title_fullStr Caffeine and Clinical Outcomes in Premature Neonates
title_full_unstemmed Caffeine and Clinical Outcomes in Premature Neonates
title_short Caffeine and Clinical Outcomes in Premature Neonates
title_sort caffeine and clinical outcomes in premature neonates
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6915633/
https://www.ncbi.nlm.nih.gov/pubmed/31653108
http://dx.doi.org/10.3390/children6110118
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