October 1990

Cardiovascular Effects of Caffeine Therapy in Preterm Infants

Author Affiliations

From the Neonatology Division, Department of Pediatrics, University of Southern California School of Medicine, Los Angeles County–University of Southern California Medical Center, Los Angeles, Calif. Dr Walther is now with the Department of Pediatrics, King/Drew Medical Center and UCLA School of Medicine.

Am J Dis Child. 1990;144(10):1164-1166. doi:10.1001/archpedi.1990.02150340110035

• Theophylline therapy increases left ventricular output in preterm infants by a combination of positive inotropic and chronotropic effects. The cardiovascular effects of caffeine were evaluated in 20 clinically stable preterm infants. Ten infants received intravenous caffeine citrate with a loading dose of 20 mg/kg and a maintenance dose of 5 mg/kg every 24 hours, and 10 infants were control subjects. Left ventricular output, stroke volume, and heart rate were measured by using a combination of two-dimensional and pulsed Doppler echocardiography and mean arterial blood pressure by oscillometry (Dinamap, Critikon, Division of McNeil Laboratories, Irvine, Calif) before the start and on days 1, 2, 3, and 7 of caffeine therapy and 7 days after discontinuation of therapy. Compared with controls, left ventricular output and stroke volume were significantly increased on days 1 to 7 of caffeine therapy. Caffeine led to an increase in the mean arterial blood pressure on the first 3 days of therapy, but the heart rate did not change. These data indicated that caffeine administration leads to a significant increase in left ventricular output in preterm infants and that this inotropic effect is accompanied by a pressor effect.

(AJDC. 1990;144:1164-1166)