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Neonatal respiratory distress syndrome is typically characterized by progressive exacerbation of respiratory distress shortly after birth, which is more common in preterm infants and has a high disability and mortality rate.Caffeine citrate has been used in the treatment of premature infants with respiratory distress syndrome to enhance the contraction of the diaphragm and optimize the function of respiratory muscles to accelerate the recovery of spontaneous breathing.This review summarized the use of caffeine citrate in premature infants with respiratory distress syndrome.
ABSTRACT
Neonatal respiratory distress syndrome is typically characterized by progressive exacerbation of respiratory distress shortly after birth, which is more common in preterm infants and has a high disability and mortality rate.Caffeine citrate has been used in the treatment of premature infants with respiratory distress syndrome to enhance the contraction of the diaphragm and optimize the function of respiratory muscles to accelerate the recovery of spontaneous breathing.This review summarized the use of caffeine citrate in premature infants with respiratory distress syndrome.
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OBJECTIVES@#To study the clinical features and outcome of very preterm infants withdrawn from caffeine citrate at different time points.@*METHODS@#A retrospective analysis was performed on the medical data of the preterm infants with a gestational age of <32 weeks, who were hospitalized in the Division of Neonatology, the Second Xiangya Hospital of Central South University, from January 1, 2016 to November 30, 2020. According to the time of withdrawal from caffeine citrate, the infants who met the study criteria were divided into the group with withdrawal before the last week of hospitalization and the group with withdrawal within the last week of hospitalization. The two groups were compared in terms of clinical features, features of citric caffeine use, length of hospital stay and hospital costs, change in the intensity of respiratory support, and preterm complications.@*RESULTS@#A total of 403 preterm infants were enrolled, with 285 infants in the group with withdrawal before the last week of hospitalization and 118 infants in the group with withdrawal within the last week of hospitalization. There were no significant differences in clinical features between the two groups (@*CONCLUSIONS@#A relatively long course of caffeine citrate treatment is more beneficial to the short-term clinical outcome of very preterm infants.
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Humans , Infant , Infant, Newborn , Bronchopulmonary Dysplasia , Caffeine , Citrates , Infant, Premature , Retrospective StudiesABSTRACT
OBJECTIVES@#To study the effect of different maintenance doses of caffeine citrate on the success rate of ventilator weaning in very preterm infants (gestational age of ≤32 weeks) with respiratory distress syndrome (RDS).@*METHODS@#A total of 162 preterm infants with RDS who were admitted to the hospital from January 2016 to December 2018 were enrolled in this prospective trial. These infants had a gestational age of ≤32 weeks and required invasive mechanical ventilation. They were randomly divided into a high-dose caffeine group and a low-dose caffeine group, with 81 infants in each group. Within 6 hours after birth, both groups were given caffeine at a dose of 20 mg/kg. After 24 hours, the high- and low-dose caffeine groups were given caffeine at a maintenance dose of 10 mg/kg and 5 mg/kg, respectively. The two groups were compared in terms of re-intubation rate within 48 hours after ventilator weaning, durations of ventilation and oxygen therapy, enteral feeding, weight gain, and the incidence rates of complications and adverse reactions during hospitalization.@*RESULTS@#The high-dose caffeine group had a significantly lower re-intubation rate within 48 hours after ventilator weaning than the low-dose caffeine group (@*CONCLUSIONS@#A high maintenance dose of caffeine can safely and effectively reduce the incidence rate of apnea after ventilator weaning and the failure rate of ventilator weaning in RDS preterm infants with a gestational age of ≤32 weeks, and therefore, it holds promise for clinical application.
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Humans , Infant , Infant, Newborn , Caffeine , Citrates , Infant, Premature , Prospective Studies , Respiratory Distress Syndrome, Newborn/therapy , Ventilator WeaningABSTRACT
Objective@#To investigate the effect of caffeine citrate administering at different time on outcome and neurodevelopment of premature infants.@*Methods@#A total of 113 preterm infants with gestational age less than 32 weeks and birth weight less than 1 500 g who were hospitalized and treated in the neonatal intensive care unit from January 2018 to June 2018 were enrolled.According to the time when caffeine citrate treatment was started, they were divided into early treatment group(≤1 days) with 53 infants and late treatment group(1 to 10 days) with 60 infants.A retrospective analysis was performed for their clinical data.The perinatal conditions, treatment process and clinical outcomes of the two groups were compared and the neurological development was followed up at 12 months old.@*Results@#Compared with the late treatment group, the early treatment group had a significantly shorter durations of mechanical ventilation time, oxygen therapy time, hospitalization days and a significantly lower incidence of bronchopulmonary dysplasia, patent ductus arteriosusand intraventricular hemorrhage or periventricular leukomalacia, and there were significant differences between two groups(P<0.05, respectively). The neonatal behavioral neurological assessment score in the early treatment group was higher than that in the late treatment group at 40 weeks of gestational age, and there was significant difference between two groups(P<0.05). The mental developmental index at 3 months of corrected age, the mental developmental index and psychomotor developmental index at 12 months were significantly better in the early treatment group than those in the late treatment group, and there were significant differences between two groups(P<0.05, respectively).@*Conclusion@#Early use of caffeine citrate can improve the outcome of premature infants and improve the prognosis of nervous system.
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Objective@#To investigate the clinical effects of pulmonary surfactant(PS) combined with caffeine citrate on neonatal respiratory distress syndrome(NRDS) treated with synchronized nasal intermittent positive pressure ventilation(SNIPPV).@*Methods@#We collected and analyzed 99 neonates who were diagnosed with NRDS and required SNIPPV treatment from January 2016 to June 2019 in NICU of Shengjing Hospital of China Medical University.According to the different treatment, they were divided into PS+ citrate caffeine combination group and control group.The control group(53 neonates)was treated by PS alone.The combination group(46 neonates)was treated with PS combined with caffeine citrate.The indexes of ventilator time, the time of using oxygen, length of hospital stay and complications were compared between the two groups.@*Results@#The indexes of ventilator time, the time of using oxygen and length of hospital stay of combination group were significantly shorter than those of the control group.The differences were statistically significant(P<0.05). However, the incidences of ventilator associated pneumonia, gastrointestinal dysfunction, arrhythmia and other complications were not significantly different between the two groups(P>0.05).@*Conclusion@#PS combined with caffeine citrate in the treatment of NRDS with SNIPPV could effectively improve the pulmonary function of infants.It could improve the neonatal survival rate and reduce complications.It is worth to be recommended.
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Objective To investigate the clinical effects of pulmonary surfactant ( PS) combined with caffeine citrate on neonatal respiratory distress syndrome(NRDS) treated with synchronized nasal inter-mittent positive pressure ventilation(SNIPPV). Methods We collected and analyzed 99 neonates who were diagnosed with NRDS and required SNIPPV treatment from January 2016 to June 2019 in NICU of Shengjing Hospital of China Medical University. According to the different treatment,they were divided into PS+ cit-rate caffeine combination group and control group. The control group(53 neonates)was treated by PS alone. The combination group(46 neonates)was treated with PS combined with caffeine citrate. The indexes of vent-ilator time,the time of using oxygen,length of hospital stay and complications were compared between the two groups. Results The indexes of ventilator time,the time of using oxygen and length of hospital stay of combination group were significantly shorter than those of the control group. The differences were statistically significant(P<0. 05). However,the incidences of ventilator associated pneumonia,gastrointestinal dysfunc-tion,arrhythmia and other complications were not significantly different between the two groups(P>0. 05). Conclusion PS combined with caffeine citrate in the treatment of NRDS with SNIPPV could effectively im-prove the pulmonary function of infants. It could improve the neonatal survival rate and reduce complications. It is worth to be recommended.
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OBJECTIVE: To study the compatibility of inner surface of anatomy bottle and Caffeine citrate injection.METHODS: After treated with high temperature (60 ℃, 10 days), light (5 000 Lx, 10 days), freezing and thawing (2 days for freezing at -18 ℃ and 2 days for thawing at 40 ℃ as a circulation, and repeat for 3 times), sterilizing (121 ℃, 2 h), Caffeine citrate injection packed in anatomy bottle was tested in respects of pH value, insoluble particle, glass stripping tendency before test and under the above conditions. The contents of arsenic, cadmium, lead, cobalt, manganese, vanadium, copper, lithium, barium, chromium, antimony, aluminum, boron, calcium, iron, potassium, magnesium, silicon and titanium that may dissolve by inner surface of anatomy bottle were tested by ICP method, and compared with analysis evaluation threshold (AET) of each element. RESULTS: Before the test, under high temperature, light, freezing and thawing, sterilization, and pH values of Caffeine citrate injection installed with ampoule were 4. 58, 4. 60, 4. 61, 4. 58, 4. 58. The insoluble particles were all in line with 0903 provisions stated in (four) general provisions of Chinese Pharmacopoeia (2015 edition). The inner surface of ampoule bottle glass had no stripping tendency. The arsenic, cadmium, lead, cobalt, manganese, vanadium, copper, lithium, barium, chromium, antimony, iron, magnesium and titanium were not detected in caffeine citrate injection, and the contents of aluminum, boron, calcium, potassium and silicon were far below its AET value. CONCLUSIONS: Caffeine citrate injection has no effect on inner surface of ampoule bottle.
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Objective To compare the effects of caffeine citrate and aminophylline combined with naloxone in the treatment of premature infants with apnea.Methods From March 2015 to March 2017,140 premature infants with apnea who were treated in neonatal intensive care unit in Integrated Traditional Chinese and Western Medicine Hospital of Wenzhou were selected in the research.The children were randomly divided into the study group and the control group according to the digital table,with 70 cases in each group.The control group was treated with aminophyl-line combined with naloxone,and the observation group was treated with caffeine citrate.The adverse reaction of children during the treatment was recorded,and the level of apnea was evaluated after treatment.The blood gas index of children before and after 48h treatment was compared,the mortality rate of the children was counted,and the incidence of brain injury during the 1 year follow -up was analyzed.Results After treatment for 48h,the level of PaO2in the two groups was significantly higher [study group: (10.54 ±0.41) kPa,control group: (9.66 ± 0.39) kPa] than those before treatment[study group: (7.18 ±0.26) kPa,control group: (7.21 ±0.24) kPa],and the level of PaCO2[study group: (5.31 ±0.24) kPa,control group: (5.82 ±0.25) kPa]was significantly lower than those before treatment[study group: (6.83 ±0.28) kPa,control group: (6.77 ±0.30) kPa](t＝19.153,13.624,11.271,7.304;P＝0.000,0.000,0.000,0.000),and the level of PaO2in the study group was significantly higher than that in the control group,and the level of PaCO 2in the study group was significantly lower than that in the control group(t＝6.029,4.327;P＝0.000,0.000).The overall effective rate of apnea therapy in the study group (92.86%) was significantly higher than 77.14%in the control group (χ2＝4.509,P＝0.034).The mortality rate(1.43%) and the incidence rate of brain injury (0.00%) of the study group were significantly lower than those of the control group (10.00%and 7.14%)(χ2＝4.773,5.185;P＝0.029,0.023).The incidence rate of adverse reactions (30.00%) of the study group was significantly lower than 50.00%of the control group (χ2＝5.833,P＝0.016).The endometri-al thickness of the study group was significantly lower than that of the control group (P＜0.05).The rate of ovulation success(87.84%) and pregnancy success rate (45.94%) of the study group were significantly higher than those of the control group(72.97%and 28.39%)(χ2＝5.189,4.890;P＝0.023,0.027).The rate of abortion(8.82%) of the study group was significantly lower than 33.33%of the control group (χ2＝5.242,P＝0.022).During the period of treatment,the incidence rate of adverse drug reactions (6.77%) of the study group was not significantly different from 8.11%of the control group (χ2＝0.098,P＝0.754).Conclusion Compared with aminophylline combined with naloxone treatment,caffeine citrate can significantly improve the blood gas status of apnea preterm infants,improve the overall curative effect of apnea,prevent the occurrence of neonatal death and brain injury,and reduce the adverse reactions of the children during the treatment.It is worthy of clinical application.
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Objective Discuss the clinical efficacy of caffeine citrate and aminophylline in treatment of primary apnea of prematurity.Methods 80 cases of primary apnea of prematurity were selected.They were divided into two groups randomly.The control group (40 cases) received aminophylline treatment and the observation group (40 cases) received caffeine citrate therapy.The efficacy of caffeine citrate and aminophylline in treatment of primary apnea ofprematudty was evaluated by efficacy,primary apnea episodes and disappeared time,adverse reaction during treatment.Results The effective rate of observation group was 85％,the effective rate of control group was 75％.The observation group had higher efficiency (P ＜ 0.05).The frequency of apnea of observation group was less than that of the control group.The disappearance time of observation group was shorter than that of the control group (P ＜ 0.05).During the treatment,the tachycardia,feeding intolerance,bronchopulmonary dysplasia and other adverse reactions rate of observation group was lower than that of the control group (P ＜ 0.05).Conclusion Compared with aminophylline,caffeine citrate had a good therapeutic effect of primary apnea of prematurity.It can reduce apnea frequency,eliminate clinical symptoms with high safety.It was an ideal drug for treatment of primary apnea.
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Objective To investigate the protective effect of caffeine citrate on white matter damage in 2-day-old neonatal rats induced by postnatal infection.Methods Forty-eight 2-day-old SD rats were randomly divided into the control group (group A,n =16),lipopolysaccharide(LPS) infection group (group B,n =16),and caffeine citrate intervention group (group C,n =16) according to the random table method.The newborn rats of group B and C were continuously injected LPS 0.6 mg/kg intraperitoneally for 5 days from 2 days old,and the newborn rats of group A were continuously injected by an equal volume of 9 g/L saline intraperitoneally.Group C was continuously injected by caffeine citrate 10 mg/kg intraperitoneally for 7 days from 4 days old;equal volume of 9 g/L saline was injected into group A and B for 7 days continuously.At 12 days old,8 rats of each group were sacrificed randomly to evaluate the expression of myelin basic protein(MBP) subcortical white matter by immunohistochemical method.Both sides of hippocampus of the rest 8 rats of each group were taken out in ice surface rapidly.The left hippocampus was used to detect the expression of MBP and Caspase-3 by Western blot method,and the right hippocampus was used to evaluate the MBP and Caspase-3 protein level by quantitative real-time PCR(qPCR) method.Results The mean integral optical density (IOD) of subcortical MBP positive expression in group A,group B and group C were 132.64 ± 1.94,102.43 ± 2.12,114.25 ± 2.04,and the difference was statistically significant among 3 groups (F =22.912,P ＜ 0.05).The relative expression levels of MBP mRNA of 3 groups in hippocampus were 0.79 ± 0.01,0.39 ± 0.03,0.55 ± 0.02,and the difference was statistically significant among 3 groups (F =18.584,P ＜ 0.05).The relative expression levels of MBP protein of 3 groups in hippocampus were 0.64 ± 0.03,0.31 ± 0.03,0.51 ± 0.05,and the difference was statistically significant among 3 groups (F =25.780,P ＜ 0.05).The relative expression levels of Caspase-3 mRNA of 3 groups in hippocampus were 0.34 ± 0.02,0.74 ± 0.03,0.57 ± 0.04,and the difference was statistically significant among 3 groups (F =6.105,P ＜ 0.05).The relative expression of Caspase-3 protein of 3 groups in hippocampus were 0.11 ± 0.03,0.36 ± 0.02,0.23 ± 0.03,and the difference was statistically significant among 3 groups (F =40.541,P ＜ 0.05).Conclusions Caffeine citrate has showed protective effect on white matter damage in neonatal rats of 2 days old induced by postnatal infection.The mechanism may be related to inhibition of inflammatory response and reducing apoptosis.
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Objective To investigate the effects of caffeine citrate and aminophylline in treatment of primary apnea of premature infants and its related complications. Methods A total of 152 preterm infants who were diagnosed primary apnea within 10 days after birth were randomly divided into caffeine citrate group(n=77) and aminophylline group(n =75). The changes in the time of the apnea disappeared after treating,needing oxygen,non-invasive and invasive mechanical ventilation,and the incidence of bronchopul-monary dysplasia ( BPD ) , necrotizing enterocolitis, retinopathy of prematurity, patent ductus arteriosus (PDA),intercranial hemorrhage(ICH)were compared between the two groups. Results The time of the apnea disappeared after treating[(47. 4 ± 5. 3) h],needing oxygen[(20. 5 ± 7. 6) d],non-invasive mechani-cal ventilation[(8. 7 ± 4. 2) d] and invasive mechanical ventilation[(1. 0 ± 1. 3) d] in the caffeine citrate group were significantly lower than those in the aminophylline group [ ( 54. 8 ± 6. 2 ) h, ( 24. 4 ± 8. 5 ) d, (10.4±5.3)d,(10.4±5.3)d,respectively](P0. 05). Conclusion The caffeine citrate has a better efficacy in the treating primary apnea of preterm infants than aminophylline. It can also decrease the incidence of BPD,PDA and ICH in premature infants.
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Objective To investigate the effect of caffeine citrate in the treatment of neonatal apnea and the corresponding intervention measures. Methods A total of 88 children with apnea were enrolled in this study from December 2015 to February 2017, and were randomly divided into control group and study group, 44 cases in each group.The study group on the basis of conventional therapy plus caffeine citrate, the control group on the basis of conventional therapy plus aminophylline group, two newborns with apnea were duration of treatment should be 7 for 7 days, record the treatment effect and the incidence of adverse reactions. Results The total effective rate was 88.64％ in the study group and 72.73％ in the control group (P<0.05). The incidence of adverse reactions was 11.36％ in the study group and 40.91％ in the control group (P<0.05). Conclusion The application of caffeine citrate treatment of apnea with clinical efficacy and safety of the ideal of the newborn, in the course of treatment given targeted clinical nursing intervention is conducive to the protection of newborns with apnea of quality of life and life safety.
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Objective To investigate the clinical effects and safety of Aminophylline and Caffeine citrate in the treatment of preterm infants with primary apnea. Methods 130 preterm infants with primary apnea were chosen and randomly divided into both group including the Aminophylline group (65 children) with aminophylline and the Caffeine citrate group (65 children) with Caffeine citrate on the basis of conventional intervention; and the total oxygen inhalation time, mechanical ventilation time, hospitalization time, the complications incidence with follow-up and the levels of development quotient for short-term of both groups were compared. Results The total oxygen inhalation time, the mechanical ventilation time and the hospitalization time of Caffeine citrate group were significantly shorter than aminophylline group(P<0.05). The incidence of PDA, BPD and ROP of Caffeine citrate group were significantly lower than aminophylline group(P<0.05). There was no significant difference in the incidence of intracranial hemorrhage, PVL and NEC between two groups. The development quotient levels in 24 weeks and 48 weeks after treatment of Caffeine citrate group were significantly higher than aminophylline group(P<0.05). Conclusion Compared with Aminophylline, Caffeine citrate on the basis of conventional intervention in the treatment of preterm infants with primary apnea could efficiently shorten the oxygen inhalation time, the mechanical ventilation time and clinical disease course, reduce the related complications risk and be helpful to promote the intellectual development.
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Objective To evaluate the effect of caffeine citrate on oxygen metabolism in brain and intestine in premature infants with neonatal respiratory distress syndrome (NRDS).Methods Preterm infants aged 30-34 weeks with NRDS admitted in Guangzhou Women and Children's Medical Center during May 2015 and April 2016 were enrolled.They were administrated with maintainance dose of caffeine citrate at the 2nd day after birth.The oxygen metabolism in brain and intestine 1 h before,during and after the administration were recorded by near infrared spectroscopy.Results The cerebral oxygen saturation (ScO2) showed a less significant change before,during and after treatment.While a marked increase was seen in intestinal oxygen saturation (SsO2) during and after caffeine citrate administration,as well as the change of SsO2/ScO2 than before.SsO2/ScO2 was dramatical higher in infants with nasal continuous positive airway pressure (nCPAP) than in those with incubator oxygen supply and mechanical ventilation during and after caffeine citrate treatment than before.Conclusion Caffeine citrate may improve the delivery of oxygen and may increase the oxygenation in local tissues for preterm infants with NRDS,especially for infants with nCPAP.
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Objective To analyze the clinical effect of caffeine citrate on apnea and its effect on endothelin, nitric oxide and β-endorphin in premature infants. Methods 118 children with apnea-hypoprenalia were selected and divided into experimental group and control group according to different treatment methods. The control group were treated with aminophylline, and the experimental group were treated with caffeine citrate. The clinical symptoms, endotheliolysin, nitric oxide and β-endorphin in two groups of patients were compared. Results The total effective rate of 84.75% (50/59) in the experimental group was higher than 69.49% (41/59) in the control group(P<0.05). The incidence of abdominal distension, heart rate, feeding intolerance, bronchopulmonary dysplasia and irritability were significantly lower in the experimental group than those in the control group (P <0.05) . After treatment, the levels of endotheliolysin, nitric oxide in the experimental group were significantly higher than those in the control group (P <0.05), and the level of β endorphin in the experimental group was significantly lower than that in the control group (P <0.05). Conclusion Caffeine citrate has a significant clinical effect on apnea in premature infants, and can reduce the incidence of adverse reactions.
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BACKGROUND: Current evidence suggests that intravenous magnesium sulfate might be effective for reducing migraine pain. In a recent pilot study, we showed that intravenous caffeine citrate could reduce the severity of migraine headache. The objective of this study is to investigate the efficacy of intravenous caffeine citrate vs. magnesium sulfate for management of acute migraine headache. METHODS: We conducted a prospective quasi-experimental study from January until May 2016 in two educational medical centers of Shahid Beheshti University of Medical Sciences (Shoahadaye Tajrish Hospital and Imam Hossein Hospital), Tehran, Iran. The study included patients who were referred to the emergency department and met the migraine diagnosis criteria of the International Headache Society. Patients were allocated into 2 groups receiving either 60 mg intravenous caffeine or 2 g intravenous magnesium sulfate. The pain scores, based on the visual analog scale, were recorded on admission, as well as one and two hours after receiving the drug. A Chi-Square test and student t-test were used for analysis of baseline characteristics. A Mann-Whitney U test and Wilcoxon singed rank test were used to analyze differences in the visual analogue scale (VAS) score between and within the groups respectively. RESULTS: In total, 70 patients (35 patients in each group) with the mean age of 33.1 ± 11.3 years were included (64.3% female). For the Caffeine citrate group, the median pain score decreased from 9.0 (2.0) to 5.0 (4.0) after one hour and to 3.0 (4.0) after two hours. For the magnesium sulfate group, the pain score decreased from 8.0 (2.0) to 2.0 (2.0) after one hour and to 0.0 (1.0) after two hours. Both intravenous caffeine citrate and intravenous magnesium sulfate reduced pain scores significantly but the magnesium sulfate group showed more improvement than the Caffeine citrate group after one hour (P < 0.001) and after two hours (P < 0.001). CONCLUSIONS: It is likely that both intravenous caffeine and intravenous magnesium sulfate can reduce the severity of migraine headache. Moreover, intravenous magnesium sulfate at a dose of 2 g might be superior to intravenous caffeine citrate 60 mg for the short term management of migraine headache in emergency departments.
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Humans , Caffeine , Citric Acid , Clergy , Diagnosis , Emergency Service, Hospital , Headache , Iran , Magnesium Sulfate , Magnesium , Migraine Disorders , Non-Randomized Controlled Trials as Topic , Pain Management , Pilot Projects , Prospective Studies , Visual Analog ScaleABSTRACT
Objective To investigate the clinical effect of caffeine citrate combined with continuous positive airway pressure( CPAP) in the treatment of primary apnea of prematurity.Methods 80 premature infants with primary apnea who received therapy from January 2014 to August 2015 were selected as research subjects.According to ran-dom number table,the infants were divided into two groups equally.Besides conventional treatments,the control group received treatment of caffeine citrate,while the observation group received CPAP and caffeine citrate.Then,the cura-tive efficacy,situation of apnea and adverse reactions were compared.Results The total effective rate between the observation group and the control group had statically significant difference(95.0%vs.77.5%,P0 .0 5 ) . Conclusion Caffeine citrate in combination with CPAP is effective for primary apnea of prematurity,which can sig-nificantly increase curative efficacy,lessen seizure frequency of apnea,shorten duration of seizure and disappearance time of symptoms with less adverse reactions.
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Objective To analysis the effect of caffeine citrate on pulmonary function, vascular endothelial growth factor (VEGF)and insulin like growth factor -1 (IGF-1) in the apnea syndrome rats.Methods 80 male Wistar rats were selected, 20 were randomly selected to be the control group, the rest of the rats were replicated of apnea syndrome model.The rats were randomly divided into model group, experiment group and positive drug group, 20 of each group.The experimental group was given caffeine citrate injection of 5 mg/kg intraperitoneal injection, the positive drug group was given intraperitoneal injection of aminophylline 3 mg/kg, the model group was given intraperitoneal injection of normal saline, once a day, continuously for 1 week.Pulmonary function, serum VEGF, IGF-1 levels and sleep apnea were compared after the experiment.ResuIts Compared with the positive drug group, the related indexes of pulmonary function of the experimental group increased significantly ( P<0.05 ) .Serum VEGF levels decreased significantly (P<0.05).The serum IGF-1 level increased significantly (P<0.05).The sleep apnea index decreased significantly during the period of NREM and REM.(P<0.05).ConcIusion Caffeine citrate can improve apnea syndrome rats lung function, reduce the serum VEGF level, promote the formation of serum IGF-1, reduce the sleep apnea index.
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ObjectiveTo investigate the effects of caffeine citrate (CC) on the neuronal proliferation and apoptosis and long-term learning ability in neonatal rats with hypoxia-ischemic brain damage (HIBD).MethodsForty-eight 7-day-old Sprague-Dawley neonatal rats were randomly divided into 3 groups: sham operation group (n=16), HIBD group (n=16), HIBD + caffeine citrate group (CC group,n=16). Rats in HIBD and CC groups received ligation of left common carotid artery followed by 2 hours of hypoxia to establish HIBD model. Rats in CC group were injected intraperitoneally with CC (20 mg/kg) before and at 0 min, 24 h, 48 h, and 72 h after hypoxia-ischemic (HI), and rats in the other two groups were injected intraperitoneally with an equal volume of normal saline at the corresponding time. Meanwhile, from postnatal day 10, each rat was injected intraperitoneally with 5-bromo-2’-de-oxyuridine (BrdU) (50 mg/kg) for 5 consecutive times, once every 12 h. On postnatal day 12, BrdU in the hippocampal dentate gyrus and cleaved caspase-3 in the hippocampal CA1 area were detected by immunohistochemistry, and neuronal apoptosis in hippocampal CA1 area were detected by TUNEL staining. On postnatal day 28, long-term learning and memory ability of rats was tested by Y maze.ResultsThere was signiifcant difference in the number of BrdU-positive cells in brain tissues of rats among three groups (F=101.38,P<0.01). The BrdU-positive cells in HIBD group and CC group were signiifcantly more than those in sham operation group (P<0.05). There was signiifcant difference in the number of cleaved caspase-3-positive cells in hippocampal CA1 area among three groups (F=379.77,P<0.01). The cleaved caspase-3-positive cells in CC group were signiif-cantly fewer than those in HIBD group but signiifcantly more than those in sham operation group (P<0.05). The TUNEL-pos-itive cells in hippocampal CA1 area were signiifcantly different among three groups (F=505.92,P<0.01) which was most in HIBD group and fewest in sham operation group and signiifcant difference was found through multiple comparison (P<0.05). The total learning number of avoiding electric shock tested by Y maze was signiifcantly different among three groups (F=32.05, P<0.01) which was most in HIBD group. Correct response rate was significantly different among three groups (F=24.99, P<0.01) which was lowest in HIBD group.ConclusionsCaffeine citrate can improve the ability of long-term learning and memory in neonatal rats with hypoxia-ischemic brain damage, the mechanism of which may be related to reducing the neuronal apoptosis after hypoxia ischemia.