Brain hemodynamic changes in preterm infants after maintenance dose caffeine and aminophylline treatment

Objective: To investigate the acute effects of low-dose caffeine and aminop hylline on cerebral blood flow in preterm infants, using both near-infrared spectroscopy (NIRS) and cerebral Doppler ultrasonography. Methods: Preterm infants with a gestational age of <32 weeks and birth weight of <1,500 g w ere randomized to receive either caffeine or aminophylline treatment for ap nea of prematurity. The study period went from 30 min before to 60 min afte r the administration of the maintenance dose of pure caffeine (2.5 mg/kg on ce a day) or aminophylline(1.25 mg/kg twice a day). NIRS was used to measur e changes in oxygenated hemoglobin (O(2)Hb), deoxygenated hemoglobin (HHb), oxidized-reduced cytochrome aa3 (CtOx), and mean cerebral oxygen saturatio n (SmO2 = O(2)Hb/total Hb). Changes in cerebral blood volume (Delta CBV) af ter caffeine or aminophylline administration were calculated. Cerebral bloo d flow velocity (CBV) in the pericallosal artery was evaluated by cerebral Doppler ultrasounds. Results: Data collected by NIRS and cerebral Doppler u ltrasounds did not show significant differences before and after caffeine t reatment. We observed a significant increase in O(2)Hb and HHb concentratio n and in CBV at 30 min after the infusion of aminophylline, which tended to return to baseline at the end of the study period. Conclusion: Caffeine do es not significantly affect brain hemodynamics, while aminophylline induces a significant transient increase in O(2)Hb and HHb concentration and CBV. Copyright (C) 2000 S. Karger AG. Basel.