Crossley Kelly J, Allison Beth J, Polglase Graeme R, Morley Colin J, Harding Richard, Davis Peter G, Moss Timothy J M, Hooper Stuart B
The Ritchie Centre, Monash Institute of Medical Research, Monash University, Clayton, Victoria, Australia .
Pediatr Res. 2012 Jul;72(1):19-25. doi: 10.1038/pr.2012.49.
Caffeine administration is associated with a reduction in bronchopulmonary dysplasia, assisted ventilation, patent ductus arteriosus (DA) and cerebral palsy in preterm infants, but the mechanisms are unknown. Our aim was to determine the effects of acute caffeine administration on renal and pulmonary function in preterm lambs.
Lambs were delivered by caesarean section at ~126 days of gestation and ventilated with a tidal volume of 5 ml/kg, 60 breaths/min and 5 cmH(2)O positive end-expiratory pressure. After 30 minutes, lambs received 40 mg/kg caffeine i.v (n=7) or saline (controls; n=6) over 30 minutes and were ventilated for 2 hours.
Arterial caffeine concentrations reached 35.9 ± 7.8 mg/l. Urine output was significantly higher after caffeine treatment than in controls (5.86 ± 1.95 vs 0.76 ± 0.94 ml/kg, area under curve p=0.041). Mean heart rate was significantly higher after caffeine treatment than in controls (211 ± 8 vs 169 ± 15 beats per minute, p<0.05) and remained higher for the experimental period.
Caffeine did not affect pulmonary artery or DA blood flows or other renal, respiratory or cardiovascular parameters examined. Neonatal caffeine administration increased heart rate and urine output but had little effect on pulmonary function in ventilated preterm lambs.
给早产婴儿使用咖啡因与支气管肺发育不良、辅助通气、动脉导管未闭（PDA）及脑瘫的减少有关，但机制尚不清楚。我们的目的是确定急性给予咖啡因对早产羔羊肾和肺功能的影响。
在妊娠约126天时通过剖宫产分娩羔羊，以潮气量5 ml/kg、呼吸频率60次/分钟和呼气末正压5 cmH₂O进行通气。30分钟后，羔羊在30分钟内静脉注射40 mg/kg咖啡因（n = 7）或生理盐水（对照组；n = 6），并通气2小时。
动脉咖啡因浓度达到35.9±7.8 mg/l。咖啡因治疗后的尿量显著高于对照组（5.86±1.95 vs 0.76±0.94 ml/kg，曲线下面积p = 0.041）。咖啡因治疗后的平均心率显著高于对照组（211±8 vs 169±15次/分钟，p<0.05），并在实验期间一直较高。
咖啡因不影响肺动脉或动脉导管血流或其他所检测的肾、呼吸或心血管参数。给新生羔羊使用咖啡因可增加心率和尿量，但对通气的早产羔羊肺功能影响不大。
