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      Citrato de cafeína en la apnea del prematuro

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          Abstract

          Objetivo: Evaluar el uso del citrato de cafeína en recién nacidos prematuros, para evitar la aparición de apnea. Método: Estudio prospectivo con análisis descriptivo transversal de 20 recién nacidos prematuros, que por su condición de prematuros los hace más susceptibles a presentar apneas neonatales y a quienes se administró citrato de cafeína como coadyuvante a su tratamiento general. Ambiente: Maternidad "Concepción Palacios". Servicio de Pediatría. Resultados: En 19 (95 %) de los pacientes, la evolución fue satisfactoria, hubo 1 muerte neonatal (5%). En 17 casos (85%), la apnea desapareció, en las primeras 36 horas después de iniciar el tratamiento. Conclusiones: El citrato de cafeína utilizado en forma profiláctica evita la aparición de las apneas y en forma terapéutica, las mismas desaparecen.

          Translated abstract

          Objective: Evaluate use of the caffeine citrate, in new born premature, to avoid the apnea appearance. Method: Prospective study with cross-sectional descriptive of 20 new born premature, that by its condition for being premature does more susceptible to present/display neonatal apnea. All of them received caffeine citrate into the general treatment medical. Setting: Maternity "Conception Palacios". Pediatric Service Results: In 19 (95 %) of the patients, the evolution was satisfactory (alive) and in 1 (5%) she was bad (deads). In 17 cases (85 %), the apnea disappeared in the first 36 hours post beginning of the treatment. Conclusions: The caffeine citrate used in prophylactic form avoids the appearance of the apneas and in therapeutic form, they disappear.

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          Most cited references16

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          Effect of caffeine on oxygen consumption and metabolic rate in very low birth weight infants with idiopathic apnea.

          Methylxanthines are among the most commonly prescribed drugs in neonatal intensive care. This study evaluates the effect of caffeine on oxygen consumption and metabolic rate in premature infants with idiopathic apnea. Eighteen preterm infants at gestational ages from 28 to 33 weeks and birth weights of 890 to 1680 g were enrolled in the study. Nine preterm infants received caffeine therapy, and 9 served as a control group. Oxygen consumption and energy expenditure were examined before, during, and after caffeine treatment. Oxygen consumption increased significantly from 7.0 +/- 0.9 before caffeine to 8.8 +/- 0.7 mL/kg/min after 48 hours of caffeine therapy, and energy expenditure increased from 2.1 +/- 0.3 to 3.0 +/- 0.2 kcal/kg/hour. During the observation period of 4 weeks of caffeine treatment, oxygen consumption increased significantly in the caffeine group compared with the control patients. In the caffeine group, a lower environmental temperature was sufficient to maintain a normal body temperature. With similar caloric intake in both groups during the study period, daily weight gain in the control group was significantly higher (21 +/- 4 vs 42 +/- 2 g/d). None of the other parameters recorded changed during caffeine therapy. Long-term administration of caffeine in preterm infants is associated with an increase in oxygen consumption and with a reduction of weight gain. This may have implications for clinical practice as nutritional regimens need to be adjusted during this therapy.
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            Caffeine citrate: a review of its use in apnoea of prematurity.

            Apnoea of prematurity is a common condition in neonates born at less than 37 weeks' gestational age; it affects approximately 90% of premature neonates weighing under 1000 g at birth, and 25% of infants with a birthweight of less than 2500 g. Caffeine, a methylxanthine which occurs naturally in many plants, has been used for over 20 years to treat apnoea of prematurity. In a recent double-blind, placebo-controlled trial, apnoea was eliminated or reduced by at least 50% in significantly more neonates receiving caffeine citrate as first-line treatment than those receiving placebo. In a nonblind trial, caffeine citrate was more effective at reducing apnoeic episodes when compared with neonates receiving no treatment. Caffeine as first-line treatment demonstrated similar efficacy to theophylline or aminophylline (theophylline ethylenediamine) in 4 small randomised studies. Caffeine citrate was generally well tolerated in short term clinical trials, with very few adverse events reported. Caffeine was associated with fewer adverse events than theophylline in randomised trials. No differences in the incidence of individual adverse events were reported between caffeine citrate and placebo in a double-blind, randomised trial. Long term tolerability data are not yet available.
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              Neonatal apnea

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                og
                Revista de Obstetricia y Ginecología de Venezuela
                Rev Obstet Ginecol Venez
                Sociedad de Obstetricia y Ginecología de Venezuela (Caracas )
                0048-7732
                October 2005
                : 65
                : 4
                : 175-178
                Affiliations
                [1 ] Maternidad  Concepción Palacios
                Article
                S0048-77322005000400003
                7fa1423f-479a-4a78-8cfa-90409060e15a

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Venezuela

                Self URI (journal page): http://www.scielo.org.ve/scielo.php?script=sci_serial&pid=0048-7732&lng=en
                Categories
                OBSTETRICS & GYNECOLOGY

                Obstetrics & Gynecology
                Neonato,Newborn preterm,Apnea of prematurity,caffeine citrate,Pretérmino,Apnea del prematuro,Citrato de cafeína

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