Endesfelder Stefanie
Department of Neonatology, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
Antioxidants (Basel). 2024 Sep 3;13(9):1076. doi: 10.3390/antiox13091076.
Caffeine is one of the most commonly used drugs in intensive care to stimulate the respiratory control mechanisms of very preterm infants. Respiratory instability, due to the degree of immaturity at birth, results in apnea of prematurity (AOP), hyperoxic, hypoxic, and intermittent hypoxic episodes. Oxidative stress cannot be avoided as a direct reaction and leads to neurological developmental deficits and even a higher prevalence of respiratory diseases in the further development of premature infants. Due to the proven antioxidant effect of caffeine in early use, largely protective effects on clinical outcomes can be observed. This is also impressively observed in experimental studies of caffeine application in oxidative stress-adapted rodent models of damage to the developing brain and lungs. However, caffeine shows undesirable effects outside these oxygen toxicity injury models. This review shows the effects of caffeine in hyperoxic, hypoxic/hypoxic-ischemic, and intermittent hypoxic rodent injury models, but also the negative effects on the rodent organism when caffeine is administered without exogenous oxidative stress. The narrative analysis of caffeine benefits in cerebral and pulmonary preterm infant models supports protective caffeine use but should be given critical consideration when considering caffeine treatment beyond the recommended corrected gestational age.
咖啡因是重症监护中最常用的药物之一，用于刺激极早产儿的呼吸控制机制。由于出生时的不成熟程度，呼吸不稳定会导致早产儿呼吸暂停（AOP）、高氧、低氧和间歇性低氧发作。氧化应激作为一种直接反应无法避免，并会导致早产儿进一步发育过程中的神经发育缺陷，甚至呼吸系统疾病的患病率更高。由于咖啡因早期使用已证实具有抗氧化作用，因此可以观察到对临床结局有很大的保护作用。在针对发育中的脑和肺损伤的氧化应激适应性啮齿动物模型中应用咖啡因的实验研究中，也令人印象深刻地观察到了这一点。然而，在这些氧毒性损伤模型之外，咖啡因会表现出不良影响。本综述展示了咖啡因在高氧、低氧/缺氧缺血和间歇性低氧啮齿动物损伤模型中的作用，但也展示了在无外源性氧化应激情况下给予咖啡因时对啮齿动物机体的负面影响。对咖啡因在脑和肺早产儿模型中的益处进行的叙述性分析支持了咖啡因的保护性使用，但在考虑超过推荐矫正胎龄的咖啡因治疗时应予以批判性考虑。
