Caffeine, Bronchopulmonary Dysplasia and Neurodevelopmental Outcomes in Premature Infants

Vasantha H.S. Kumar*

Caffeine, Bronchopulmonary Dysplasia and Neurodevelopmental Outcomes in Premature Infants.

Caffeine is the most widely used psychoactive drug in adults and children in the world. Its main beneficial effects include maintaining alertness, postponing fatigue and elevating mood by acting as a central nervous system stimulant in low to moderate doses. In a way, it is a magic drug for most of the world’s population without a prescription! Moderate caffeine consumption very rarely leads to health risks. However, higher doses of caffeine produce symptoms such as anxiety, insomnia, restlessness, and tachycardia. The habitual use of caffeine can cause physical dependence that displays as caffeine withdrawal symptoms that harm normal functioning in adults. Recently, children and adolescents are the fastest segments of caffeine consumption with sales of energy drinks containing high doses of caffeine on the rise.

The first study to evaluate abnormalities in sleep architecture and breathing pattern in children aged 5-12-years, demonstrated that neonatal caffeine therapy has no long-term effects on sleep duration or sleep apnea during childhood. Ex-preterm infants, regardless of caffeine status, are at risk for obstructive sleep apnea and periodic limb movements in later childhood. Caffeine treatment improved expiratory flow rates in mid-childhood, which is related to earlier extubations
and less severity of BPD in these infants.
The benefits of earlier administration of caffeine on BPD may be related to the unique physiology of the fetus and the premature neonate modulated by the ductus arteriosus. Studies on cardiac and cerebral physiology with caffeine, especially in neonates are lacking at this time. However, several studies have tried to address mechanistic or molecular mechanisms of action, especially in animal hyperoxia models.

Pediatr Neonatal Nurs Open J. 2018; 5(1): 29-36. doi: 10.17140/PNNOJ-5-130