论文部分内容阅读
Background: A single high loading dose of 25 mg/kg caffeine has been shown to be effective for the prevention of apnoea, but may result in considerable reduct ions in blood flow velocity (BFV) in cerebral and intestinal arteries. Objective : To assess the effects of two loading doses of 12.5 mg/kg caffeine given four h ours apart on BFV in cerebral and intestinal arteries, left ventricular output (LVO), and plasma caffeine concentrations in preterm infants. Design: Sixteen pre term neonates of < 34 weeks gestation were investigated one hour after the first oral dose and one, two, and 20 hours after the second dose by Doppler sonograph y. Results: The mean (SD) plasma caffeine concentrations were 31 (7) and 29 (7) mg/l at two and 20 hours respectively after the second dose. One hour after the first dose, none of the circulatory variables had changed significantly. One hou r after the second caffeine dose, mean BFV in the internal carotid artery and an terior cerebral artery showed significant reductions of 17%and 19%(P=0.01 and P=0.003 respectively). BFV in the coeliac artery and superior mesenteric artery, LVO, PCO2, and respiratory rate had not changed significantly. Total vascular r esistance, calculated as the ratio of mean blood pressure to LVO, had increased significantly one and two hours after the second dose (P=0.049 and P=0.023 respe ctively). Conclusion: A divided high loading dose of 25 mg/kg caffeine given fou r hours apart had decreased BFV in cerebral arteries after the second dose, wher eas BFV in intestinal arteries and LVO were not affected.
Background: A single high loading dose of 25 mg / kg caffeine has been shown to be effective for the prevention of apnoea, but may result in considerable reductances in blood flow velocity (BFV) in cerebral and intestinal arteries. Objective: To assess the effects of two loading doses of 12.5 mg / kg caffeine given four h ours apart on BFV in cerebral and intestinal arteries, left ventricular output (LVO), and plasma caffeine concentrations in preterm infants. Design: Sixteen pre term neonates of <34 weeks gestation were incubated for one hour after the first oral dose and one, two, and 20 hours after the second dose by Doppler sonograph y.Results: The mean (SD) plasma caffeine concentrations were 31 (7) and 29 (7) mg / l at One hour after the first dose, none of the circulatory variables had changed significantly. One hou r after the second caffeine dose, mean BFV in the internal carotid artery and an terior cerebral artery showed signi BFV in the coeliac artery and superior mesenteric artery, LVO, PCO2, and respiratory rate had not changed significantly. Total vascular r esistance, calculated as the ratio of mean blood pressure to LVO, had increased significantly one and two hours after the second dose (P = 0.049 and P = 0.023 respe ctively). Conclusion: A divided high loading dose of 25 mg / kg caffeine given fou r hours separated had decreased BFV in cerebral arteries after the second dose, wher eas BFV in intestinal arteries and LVO were not affected.