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Lung function in immature baboons with respiratory distress syndrome receiving early caffeine therapy: A pilot study
Author(s) -
Yoder B.,
Thomson M.,
Coalson J.
Publication year - 2005
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2005.tb01794.x
Subject(s) - caffeine , medicine , respiratory distress , respiratory system , plethysmograph , lung function , anesthesia , lung
Aim: The cardiopulmonary effects of early caffeine therapy in surfactant‐treated immature baboons were measured. Methods: Nine 125‐d (term=185 d) baboons receiving caffeine citrate at 1 and 12 h age as part of a pilot study on the use of nasal CPAP at 24 h were compared to six untreated animals destined for prolonged ventilator support. All received surfactant prior to their first breath and again at 6 h age. Serial physiologic and ventilatory parameters were recorded. Lung mechanics were measured by body plethysmography. Data were compared from 1 through 24 h age. Results: There were no between‐group differences in any study variables prior to caffeine therapy at 1 h age. Airway resistance (R A ) was significantly lower in caffeine‐treated compared to non‐caffeine‐treated animals at 12 and 24 h age [median (range)12 h: 47 (35–107) cm H 2 O/l/s to 135 (120–259) cm H 2 O/l/s; and 24 h: 93(60–137) cm H 2 O/l/s to 211 (86–235) cm H 2 O/l/s; p <0.05]. Respiratory system compliance (C RS ) was higher in caffeine‐treated compared to non‐caffeine‐treated animals at 18 and 24 h age [median (range) 18 h: 0.60 (0.29–1.58) ml/cm H 2 O/kg to 0.39 (0.33–0.46) ml/cm H 2 O/kg; and 24 h: 0.68 (0.36–1.20) ml/cm H 2 O/kg to 0.36 (0.33–0.55) ml/cm H 2 O/kg; p <0.05]. Ventilatory efficiency index and arterial/alveolar ratio significantly improved in caffeine‐treated animals over the 24‐h study period ( p <0.05, repeated measures ANOVA). Conclusions: In this pilot study, early caffeine treatment, combined with prophylactic surfactant therapy, was associated with better lung function during the initial 24 h of life. This combined approach may facilitate earlier extubation or prophylactic efforts to support infants on nasal CPAP. Randomized, controlled investigation is warranted.