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The effect of caffeine loading on cerebral autoregulation in preterm infants
Author(s) -
Huvanandana Jacqueline,
Thamrin Cindy,
Hinder Murray,
McEwan Alistair,
Tracy Mark B.
Publication year - 2019
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.14636
Subject(s) - medicine , caffeine , cerebral autoregulation , anesthesia , autoregulation , correlation coefficient , correlation , cardiology , blood pressure , statistics , mathematics , geometry
Abstract Aim To evaluate cerebral autoregulation changes in preterm infants receiving a loading dose of caffeine base. Methods In a cohort of 30 preterm infants, we extracted measures of cerebral autoregulation using time and frequency domain techniques to determine the correlation between mean arterial pressure (MAP) and tissue oxygenation index (TOI) signals. These measures included the cerebral oximetry index (COx), cross‐correlation and coherence measures, and were extracted prior to caffeine loading and in the 2 hours following administration of 10 mg/kg caffeine base. Results We observed acute reductions in time domain correlation measures, including the cerebral oximetry index (linear mixed model coefficient −0.093, standard error 0.04; p = 0.028) and the detrended cross‐correlation coefficient (ρ 5 coefficient −0.13, standard error 0.055; p = 0.025). These reductions suggested an acute improvement in cerebral autoregulation. Features from detrended cross‐correlation analysis also showed greater discriminative value than other methods in identifying changes prior to and following caffeine administration. Conclusion We observed a reduced correlation between MAP and TOI from near‐infrared spectroscopy following caffeine administration. These findings suggest an acute enhanced capacity for cerebral autoregulation following a loading dose of caffeine in preterm infants, contributing to our understanding of the physiological impact of caffeine therapy.