Surgery, Pediatric, Obstetric and Gynecology Department, University of Murcia, Murcia, Spain.
Biomedical Research Institute Virgen de la Arrixaca of Murcia (IMIB-Arrixaca), Murcia, Spain.
Pediatr Pulmonol. 2020 Jan;55(1):102-107. doi: 10.1002/ppul.24540. Epub 2019 Oct 6.
To know the effect of caffeine therapy on infant lung function in preterm infants with a gestational age less than 31 weeks.
Forced vital capacity (FVC), forced expiratory volume at 0.5 seconds (FEV ), and forced expiratory flows were measured by raised volume rapid thoracoabdominal compression technique; functional residual capacity was measured by plethysmography (FRC ). Compliance of the respiratory system was measured by a single interruption technique (Crs). The Student t test was used to compare lung function measurements between the two groups: treated versus nontreated with caffeine. A multivariate analysis was carried out considering each and every lung function parameter (z-score) as the dependent variable; and gender, gestational age, birth weight (z-score), corrected age, invasive mechanical ventilation (yes/no), and bronchopulmonary dysplasia (BPD) diagnosis (yes/no) as independent ones. Additionally, stratified analyses by BPD diagnosis were performed.
The multivariate analysis showed significant higher z-scores of FVC and FEV in preterm infants treated with caffeine (P = .004 and P = .024, respectively). This result only being significant in the group of non-BPD infants (P = .021 and P = .042), after stratifying by BPD diagnosis. Differences were not found in z-scores of FEV0.5/FVC, FEF75, FEF25-75, FRCpleth, nor Crs.
Lung function (FVC and FEV ) is improved in infants born under 31 weeks of gestation when treated with caffeine. This improvement is driven by the group of infants who did not suffer from BPD. Overall, our results show that there is an early beneficial effect of caffeine treatment in infant lung function.
了解小于 31 孕周早产儿应用咖啡因治疗对其肺功能的影响。
采用容积快速胸廓加压法测定用力肺活量（FVC）、0.5 秒用力呼气容积（FEV ）和呼气流量；体描法测定功能残气量（FRC）；单次中断技术测定呼吸系统顺应性（Crs）。采用 Student t 检验比较咖啡因治疗组与未治疗组的肺功能测量值。采用多元分析，将每个肺功能参数（z 评分）作为因变量；性别、胎龄、出生体重（z 评分）、矫正胎龄、有创机械通气（是/否）和支气管肺发育不良（BPD）诊断（是/否）作为自变量。此外，还进行了 BPD 诊断分层分析。
多元分析显示，咖啡因治疗组早产儿的 FVC 和 FEV z 评分显著更高（P 值分别为.004 和.024）。这种结果仅在非 BPD 婴儿组中具有统计学意义（P 值分别为.021 和.042），在 BPD 诊断分层后。FEV0.5/FVC、FEF75、FEF25-75、FRCpleth 和 Crs 的 z 评分差异无统计学意义。
在 31 周胎龄以下的早产儿中应用咖啡因治疗可改善其肺功能（FVC 和 FEV ）。这种改善是由未患 BPD 的婴儿组驱动的。总的来说，我们的结果表明咖啡因治疗对婴儿肺功能有早期的有益影响。
