Abstract | BACKGROUND: METHODS: This study aimed to assess the short-term hemodynamic effects on systemic blood flow and ductal shunting flow after loading standard doses of intravenous caffeine in preterm infants. Echocardiographic studies were performed by a single investigator, before and at 1 hour and 4 hours after an intravenous infusion of a loading dose as 20 mg/kg caffeine citrate for 30 minutes. RESULTS: In 25 preterm infants with PDA, left ventricular output decreased progressively during 4 hours after caffeine loading. Superior vena cava (SVC) flow decreased and ductal shunting flow increased at 1 hour and then recovered at 4-hour to baseline values. A diameter of PDA significantly decreased only at 4-hour after caffeine loading. There were no significant changes of these hemodynamic parameters in 29 preterm infants without PDA. CONCLUSION: In preterm infants with PDA, a standard intravenous loading dose of 20 mg/kg caffeine citrate was associated with increasing ductal shunting flow and decreasing SVC flow (as a surrogate for systemic blood flow) 1 hour after caffeine loading, however, these hemodynamic parameters recovered at 4 hours according to partial constriction of the ductus arteriosus. Close monitoring of hemodynamic changes would be needed to observe the risk for pulmonary over-circulation or systemic hypo-perfusion due to transient increasing ductal shunting flow during caffeine loading in preterm infants with PDA.
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Authors | Jihye Hwang, Yu Seon Kim, Jeong Hee Shin, Byung Min Choi |
Journal | Journal of Korean medical science
(J Korean Med Sci)
Vol. 33
Issue 4
Pg. e25
(Jan 22 2018)
ISSN: 1598-6357 [Electronic] Korea (South) |
PMID | 29318792
(Publication Type: Journal Article)
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Copyright | © 2018 The Korean Academy of Medical Sciences. |
Chemical References |
- Citrates
- Caffeine
- caffeine citrate
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Topics |
- Administration, Intravenous
- Birth Weight
- Caffeine
(pharmacology, therapeutic use)
- Citrates
(pharmacology, therapeutic use)
- Ductus Arteriosus
(physiology)
- Ductus Arteriosus, Patent
(drug therapy, physiopathology)
- Echocardiography
- Female
- Gestational Age
- Hemodynamics
(drug effects)
- Humans
- Infant, Newborn
- Infant, Premature
- Male
- Vena Cava, Superior
(physiology)
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