Subscribe to RSS
DOI: 10.1055/s-0034-1365397
Koffein zur Behandlung der Frühgeborenenapnoen
Publication History
Publication Date:
19 May 2014 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00023625/201402/lookinside/thumbnails/10.1055-s-0034-1365397-1.jpg)
Einleitung
In den letzten Jahren stellte die Etablierung der Therapie mit Methylxanthinen, insbesondere des Koffeins, in der Neonatologie eines der wichtigsten Elemente zur Behandlung der Frühgeborenenapnoen dar. Die Effektivität und Sicherheit der Behandlung wurde in einer Anzahl von Studien nachgewiesen. Koffein verbessert nicht nur die Apnoehäufigkeit selbst, sondern reduziert auch das Risiko für eine bronchopulmonale Dysplasie, eine Reintubation und einen offenen Ductus arteriosus Botalli [1]. Die Behandlung sehr kleiner Frühgeborener < 1250 g Geburtsgewicht ist in Zusammenhang mit der günstigeren Prognose der Patienten im Vergleich zur Placebogabe auch kosteneffektiver, zumindest anhand der Daten des kanadischen Gesundheitssystems [2].
-
Literatur
- 1 Spitzer AR. Evidence-based methylxanthine use in the NICU. Clin Perinatol 2012; 39 (1) 137-148
- 2 Dukhovny D et al. Economic evaluation of caffeine for apnea of prematurity. Pediatrics 2011; 127 (1) e146-155
- 3 Supcun S et al. Caffeine increases cerebral cortical activity in preterm infants. J Pediatr 2010; 156 (3) 490-491
- 4 Rivkees SA, Wendler CC. Adverse and protective influences of adenosine on the newborn and embryo: implications for preterm white matter injury and embryo protection. Pediatr Res 2011; 69 (4) 271-278
- 5 Tanaka K et al. Comparative effects of respiratory stimulants on hypoxic neuronal cell injury in SH-SY5Y cells and in hippocampal slice cultures from rat pups. Pediatr Int 2013; 55 (3) 320-327
- 6 Kumral A et al. Genetic basis of apnoea of prematurity and caffeine treatment response: role of adenosine receptor polymorphisms: genetic basis of apnoea of prematurity. Acta Paediatr 2012; 101 (7) e299-e303
- 7 Clyman RI, Roman C. The effects of caffeine on the preterm sheep ductus arteriosus. Pediatr Res 2007; 62 (2) 167-169
- 8 Anderson BJ et al. Caffeine overdose in a premature infant: clinical course and pharmacokinetics. Anaesth Intensive Care 1999; 27 (3) 307-311
- 9 Ergenekon E et al. Caffeine intoxication in a premature neonate. Paediatr Anaesth 2001; 11 (6) 737-739
- 10 Schmidt B et al. Caffeine therapy for apnea of prematurity. N Engl J Med 2006; 354 (20) 2112-2121
- 11 Schmidt B et al. Survival without disability to age 5 years after neonatal caffeine therapy for apnea of prematurity. JAMA 2012; 307 (3) 275-282
- 12 Schmidt B et al. Long-term effects of caffeine therapy for apnea of prematurity. N Engl J Med 2007; 357 (19) 1893-1902
- 13 Francart SJ, Allen MK, Stegall-Zanation J. Apnea of prematurity: caffeine dose optimization. J Pediatr Pharmacol Ther 2013; 18 (01) 45-52
- 14 Gray PH et al. Caffeine citrate for very preterm infants: Effects on development, temperament and behaviour. J Paediatr Child Health 2011; 47 (04) 167-172
- 15 Steer PA et al. Periextubation caffeine in preterm neonates: a randomized dose response trial. J Paediatr Child Health 2003; 39 (07) 511-515
- 16 Scanlon JE et al. Caffeine or theophylline for neonatal apnoea?. Arch Dis Child 1992; 67 (04) 425-428
- 17 Lee TC et al. Population pharmacokinetics of intravenous caffeine in neonates with apnea of prematurity. Clin Pharmacol Ther 1997; 61 (06) 628-640
- 18 Schoen K et al. Use of Methylxanthine Therapies for the Treatment and Prevention of Apnea of Prematurity. Paediatr Drugs 2014; 16: 169-177
- 19 Patel P et al. Dried blood spots and sparse sampling: a practical approach to estimating pharmacokinetic parameters of caffeine in preterm infants. Br J Clin Pharmacol 2013; 75 (03) 805-813
- 20 Natarajan G et al. Therapeutic drug monitoring for caffeine in preterm neonates: an unnecessary exercise?. Pediatrics 2007; 119 (05) 936-940
- 21 Chavez ValdezR et al. Correlation between serum caffeine levels and changes in cytokine profile in a cohort of preterm infants. J Pediatr 2011; 158 (01) 57-64
- 22 Henderson-Smart DJ, De Paoli AG. Methylxanthine treatment for apnoea in preterm infants. Cochrane Database Syst Rev 2010; (12) CD000140
- 23 Henderson-Smart DJ, Steer PA. Caffeine versus theophylline for apnea in preterm infants. Cochrane Database Syst Rev 2010; CD000273
- 24 Martin RJ, Abu-Shaweesh JM. Control of breathing and neonatal apnea. Biol Neonate 2005; 87 (04) 288-295
- 25 Gannon BA. Theophylline or caffeine: which is best for apnea of prematurity?. Neonatal Netw 2000; 19 (08) 33-36
- 26 Aiba T et al. Cellular and ionic mechanism for drug-induced long QT syndrome and effectiveness of verapamil. J Am Coll Cardiol 2005; 45 (02) 300-307
- 27 Batchvarov VN et al. QT-RR relationship in healthy subjects exhibits substantial intersubject variability and high intrasubject stability. Am J Physiol Heart Circ Physiol 2002; 282 (06) H2356-H2363
- 28 Drici MD, Barhanin J. Cardiac K+ channels and drug-acquired long QT syndrome. Therapie 2000; 55 (01) 185-193
- 29 Miyata M et al. Dynamic QT/RR relationship of cardiac conduction in premature infants treated with low-dose doxapram hydrochloride. J Perinat Med 2007; 35 (04) 330-333
- 30 Alvaro R et al. Small preterm infants (less than or equal to 1500 g) have only a sustained decrease in ventilation in response to hypoxia. Pediatr Res 1992; 32 (04) 403-406
- 31 Yost CS. A new look at the respiratory stimulant doxapram. CNS Drug Rev 2006; 12 (03) 236-249
- 32 Dani C et al. Brain hemodynamic effects of doxapram in preterm infants. Biol Neonate 2006; 89 (02) 69-74
- 33 Poets CF, Darraj S, Bohnhorst B. Effect of doxapram on episodes of apnoea, bradycardia and hypoxaemia in preterm infants. Biol Neonate 1999; 76 (04) 207-213
- 34 Sreenan C et al. Isolated mental developmental delay in very low birth weight infants: association with prolonged doxapram therapy for apnea. J Pediatr 2001; 139 (06) 832-837
- 35 Fischer C et al. Doxapram and hypokalaemia in very preterm infants. Arch Dis Child Fetal Neonatal Ed 2013; 98 (05) F416-F418
- 36 Greenwood DC et al. Caffeine intake during pregnancy, late miscarriage and stillbirth. Eur J Epidemiol 2010; 25 (04) 275-280
- 37 Jarosz M, Wierzejska R, Siuba M. Maternal caffeine intake and its effect on pregnancy outcomes. Eur J Obstet Gynecol Reprod Biol 2012; 160 (02) 156-160
- 38 Laughon SK et al. Caffeine and insulin resistance in pregnancy. Am J Perinatol 2011; 28 (07) 571-578
- 39 Schmidt RJ et al. Caffeine, selected metabolic gene variants, and risk for neural tube defects. Birth Defects Res A Clin Mol Teratol 2010; 88 (07) 560-569
- 40 Browne ML et al. Maternal caffeine intake and risk of selected birth defects in the National Birth Defects Prevention Study. Birth Defects Res A Clin Mol Teratol 2011; 91 (02) 93-101
- 41 Hentges CR et al. Serum levels of caffeine in umbilical cord and apnea of prematurity. J Pediatr (Rio J) 2010; 86 (02) 137-142
- 42 Loomans EM et al. Caffeine intake during pregnancy and risk of problem behavior in 5- to 6-year-old children. Pediatrics 2012; 130 (02) e305-e313
- 43 Santos IS, Matijasevich A, Domingues MR. Maternal caffeine consumption and infant nighttime waking: prospective cohort study. Pediatrics 2012; 129 (05) 860-868
- 44 Eichenwald EC, Aina A, Stark AR. Apnea frequently persists beyond term gestation in infants delivered at 24 to 28 weeks. Pediatrics 1997; 100 (03) 354-359
- 45 Comer AM, Perry CM, Figgitt DP. Caffeine citrate: a review of its use in apnoea of prematurity. Paediatr Drugs 2001; 3 (01) 61-79
- 46 Barrington K, Finer N. The natural history of the appearance of apnea of prematurity. Pediatr Res 1991; 29 (04) 372-375
- 47 Henderson-Smart DJ. The effect of gestational age on the incidence and duration of recurrent apnoea in newborn babies. Aust Paediatr J 1981; 17 (04) 273-276
- 48 Peter CS et al. Gastroesophageal reflux and apnea of prematurity: no temporal relationship. Pediatrics 2002; 109 (01) 8-11
- 49 Poets CF, Langner MU, Bohnhorst B. Effects of bottle feeding and two different methods of gavage feeding on oxygenation and breathing patterns in preterm infants. Acta Paediatr 1997; 86 (04) 419-423
- 50 Ruggins NR. Pathophysiology of apnoea in preterm infants. Arch Dis Child 1991; 66 (01) 70-73
- 51 Milner AD et al. Upper airways obstruction and apnoea in preterm babies. Arch Dis Child 1980; 55 (01) 22-25
- 52 Waggener TB et al. Mixed and obstructive apneas are related to ventilatory oscillations in premature infants. J Appl Physiol 1989; 66 (06) 2818-2826
- 53 Martin RJ, Abu-Shaweesh JM, Baird TM. Apnoea of prematurity. Paediatr Respir Rev 2004; 5: 377-382
- 54 Gauda EB et al. Maturation of peripheral arterial chemoreceptors in relation to neonatal apnoea. Semin Neonatol 2004; 9 (03) 181-194
- 55 Poets CF. Atemregulation beim Neugeborenen. In: Jorch G, Hübler A. Neonatologie – Die Medizin des Früh- und Reifgeborenen. Stuttgart: Thieme; 2010: 181-184
- 56 Bandla HP et al. Protein kinase C modulates ventilatory patterning in the developing rat. Am J Respir Crit Care Med 1999; 159 (03) 968-973
- 57 Dreshaj IA et al. CO2-induced prolongation of expiratory time during early development. Respir Physiol 1999; 116 (02) 125-132
- 58 Dreshaj IA, Haxhiu MA, Martin RJ. Role of the medullary raphe nuclei in the respiratory response to CO2 . Respir Physiol 1998; 111 (01) 15-23
- 59 Duara S, Silva NetoG, Claure N. Role of respiratory muscles in upper airway narrowing induced by inspiratory loading in preterm infants. J Appl Physiol 1994; 77 (01) 30-36
- 60 Wulbrand H, Von Zezschwitz G, Bentele KH. Submental and diaphragmatic muscle activity during and at resolution of mixed and obstructive apneas and cardiorespiratory arousal in preterm infants. Pediatr Res 1995; 38 (03) 298-305
- 61 Poets CF, Samuels MP, Southall DP. On sudden severe bradycardia secondary to hypoxemia. Pediatr Pulmonol 1992; 12 (01) 59-60
- 62 Poets CF et al. Determinants of lung volume in spontaneously breathing preterm infants. Am J Respir Crit Care Med 1997; 155 (02) 649-653
- 63 Numa AH, Newth CJ. Anatomic dead space in infants and children. J Appl Physiol 1996; 80 (05) 1485-1489
- 64 Fleming PJ, Bryan AC, Bryan MH. Functional immaturity of pulmonary irritant receptors and apnea in newborn preterm infants. Pediatrics 1978; 61 (04) 515-518
- 65 Stransky A, Szereda-Przestaszewska M, Widdicombe JG. The effects of lung reflexes on laryngeal resistance and motoneurone discharge. J Physiol 1973; 231 (03) 417-438
- 66 Pickens DL, Schefft G, Thach BT. Prolonged apnea associated with upper airway protective reflexes in apnea of prematurity. Am Rev Respir Dis 1988; 137 (01) 113-118
- 67 Kattwinkel J. Neonatal apnea: pathogenesis and therapy. J Pediatr 1977; 90 (03) 342-347
- 68 Poets CF et al. Reduced haemoglobin levels in infants presenting with apparent life-threatening events – a retrospective investigation. Acta Paediatr 1992; 81 (04) 319-321
- 69 Rigatto H, Brady JP. Periodic breathing and apnea in preterm infants. II. Hypoxia as a primary event. . Pediatrics 1972; 50 (02) 219-228
- 70 Poets CF, Pauls U, Bohnhorst B. Effect of blood transfusion on apnoea, bradycardia and hypoxaemia in preterm infants. Eur J Pediatr 1997; 156 (04) 311-316
- 71 Westkamp E et al. Blood transfusion in anemic infants with apnea of prematurity. Biol Neonat 2002; 82 (04) 228-232
- 72 Henderson-Smart DJ, Steer P. Methylxanthine treatment for apnea in preterm infants. Cochrane Database Syst Rev 2001; CD000140 3
- 73 Perlman JM, Volpe JJ. Episodes of apnea and bradycardia in the preterm newborn: impact on cerebral circulation. Pediatrics 1985; 76 (03) 333-338
- 74 Poets CF et al. The relationship between bradycardia, apnea, and hypoxemia in preterm infants. Pediatr Res 1993; 34 (02) 144-147
- 75 Poets CF, Roth B, Bohnhorst B. Therapie idiopathischer Apnoen, Bradykardien und Hypoxämien bei Frühgeborenen. AWMF 2009; Nr. 024/013 (GNPI)
- 76 Vatlach S et al. Safety Profile Comparison between Extemporaneous and a Licensed Preparation of Caffeine Citrate in Preterm Infants with Apnea of Prematurity. Neonatology 2013; 105 (02) 108-111
- 77 Henderson-Smart DJ, Davis PG. Prophylactic methylxanthines for endotracheal extubation in preterm infants. Cochrane Database Syst Rev 2010; CD000139 12
- 78 Mathew OP. Apnea of prematurity: pathogenesis and management strategies. J Perinatol 2011; 31 (05) 302-310