Thomson A H, Kerr S, Wright S
Simpson Memorial Maternity Pavilion, Royal Infirmary of Edinburgh NHS Trust, Scotland.
Ther Drug Monit. 1996 Jun;18(3):245-53. doi: 10.1097/00007691-199606000-00005.
The population pharmacokinetics of caffeine were investigated in 60 neonates and young infants using data collected during routine therapeutic drug monitoring. Clearance was influenced by body weight and postnatal age, and increased in the presence of dexamethasone. No clinical factors were identified that influenced volume of distribution. The population pharmacokinetic parameter estimates were then tested prospectively in a further 20 neonates. Although they produced unbiased results, the dexamethasone effect could not be identified. A final analysis using all 80 patients found clearance (L/day) = 0.14 x weight (kg) + 0.0024 x postnatal age (days) (+/- 20%) and volume of distribution = 0.82 L (+/- 24%). Simulations based on these results indicated that the current dosage guidelines of 20 mg/kg loading dose of caffeine citrate followed by a 5 mg/kg/day maintenance dose should achieve concentrations within the traditional target range in > 70% of neonates.
利用常规治疗药物监测收集的数据，对60名新生儿和婴幼儿的咖啡因群体药代动力学进行了研究。清除率受体重和出生后年龄的影响，在使用地塞米松时会增加。未发现影响分布容积的临床因素。然后，在另外20名新生儿中对群体药代动力学参数估计值进行了前瞻性测试。尽管结果无偏倚，但未发现地塞米松的作用。对所有80名患者进行的最终分析发现，清除率（升/天）= 0.14×体重（千克）+ 0.0024×出生后年龄（天）（±20%），分布容积 = 0.82升（±24%）。基于这些结果的模拟表明，当前柠檬酸咖啡因20毫克/千克负荷剂量，随后5毫克/千克/天维持剂量的给药指南应能使超过70%的新生儿体内浓度达到传统目标范围。
