Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.
Neonatal Intensive Care Unit, King's College Hospital, London, UK.
J Perinat Med. 2024 Mar 18;52(5):556-560. doi: 10.1515/jpm-2023-0492. Print 2024 Jun 25.
We hypothesized that caffeine would be associated with a transient reduction in the right-to-left shunt and V/Q. We aimed to explore the temporal effects of caffeine on right-to-left shunt, ventilation perfusion ratio (V/Q) and shift of the oxyhaemoglobin dissociation curve (ODC) in premature ventilated infants.
Retrospective cohort study at a tertiary neonatal unit of infants born at less than 31 weeks of gestation that were mechanically ventilated on day three of life. The non-invasive method of the ODC was used to determine the right-to-left shunt, V/Q and shift before and at 1, 4 and 20 h after a maintenance dose of caffeine citrate.
A total of 21 infants were included with a median (range) gestational age of 27 (23.7-30.7) weeks. The median shunt percentage was significantly reduced, compared to baseline at 1 h (8 (range: 7-9) % vs. 4 (range: 0-6) %, p=0.042) and 4 h post caffeine administration (8 (range: 7-9) % vs. 0 (range: 0-3) %, p=0.042), but the V/Q and the right shift of the ODC did not differ significantly between these time points. At 20 h, there were no significant differences between these indices compared to baseline values.
Caffeine led to a transient decrease in intrapulmonary shunt from one to 4 h after administration and this may be due to its diuretic action.
我们假设咖啡因会导致右向左分流和 V/Q 短暂减少。我们旨在探讨咖啡因对早产儿机械通气后第三天右向左分流、通气灌注比（V/Q）和氧合血红蛋白解离曲线（ODC）偏移的时间效应。
这是一项在一家三级新生儿病房进行的回顾性队列研究，纳入了胎龄小于 31 周且在出生后第三天进行机械通气的婴儿。使用 ODC 的非侵入性方法来确定咖啡因枸橼酸盐维持剂量前和后 1、4 和 20 小时的右向左分流、V/Q 和偏移。
共纳入 21 名婴儿，中位（范围）胎龄为 27（23.7-30.7）周。与基线相比，1 小时（8%（范围：7-9%） vs. 4%（范围：0-6%），p=0.042）和 4 小时后咖啡因给药时（8%（范围：7-9%） vs. 0%（范围：0-3%），p=0.042）的分流百分比显著降低，但 V/Q 和 ODC 的右移在这些时间点之间没有显著差异。20 小时时，与基线值相比，这些指数没有显著差异。
咖啡因在给药后 1 至 4 小时导致肺内分流短暂减少，这可能与其利尿作用有关。
