الفهرس | Only 14 pages are availabe for public view |
Abstract This study aimed to elucidate the effect of caffeine administration on cerebral cortical activity in preterm infants, where Amplitude-integrated electroencephalography was used to monitor cerebral function changes during caffeine administration, secondary aim was to study the effect of caffeine administration on preterm infants’ electroencephalographic maturational changes by conventional and aEEG. For this purpose the current study was conducted on ٣٣ preterm infants of gestational age less than ٣٤ weeks, at NICU Ain Shams University during the period between January ٢٠١٢ and July ٢٠١٣. The studied neonates were randomly divided into two groups: group ١ (cases): preterm infants scheduled to receive a first dose of caffeine for prophylaxis or treatment of apnea. group ٢ (control): preterm infants for whom caffeine was not given.All newborns included were subjected to the following: Maternal history taking, Detailed antenatal and perinatal history, Clinical examination including (gestational age assessment using Ballard score, Apgar score estimation at ١ & ٥ minute and Anthropometric measures) and Laboratory investigations (CBC and CRP). All newborns included in group ١ were subjected to monitoring before and after caffeine administration including: cardiovascular monitoring (heart rate, capillary perfusion time, mean arterial pressure), respiratory monitoring (apnea, capillary oxygen saturation), neurological monitoring (muscle tone, arousability). AEEG(cerebral function monitor) for ١ hour before, during and ١ hour after administration of a loading dose of caffeine (٢٠mg/kg body weight), follow up conventional and aEEG for ١ hour at ٣٦ weeks of post-conceptional age to assess maturational changes in EEG. All newborns included in group ٢ were subjected to conventional EEG and aEEG for ١ hour at ٣٦ weeks of postconceptional age to compare maturity with conventional and aEEG at the same age of group ١.The results of our study showed that: there was no statistically significant difference in CRT, apnea and tone before and after caffeine administration, there was statistically significant increase in HR, mean blood arterial pressure, capillary oxygen saturation and arousability half an hour after caffeine, there was statistically significant increase in aEEG continuity (cerebral cortical activity) detected after caffeine administration compared to before, there was no statistically significant difference in electrographic seizures activity before and after caffeine administration. Cases and control were gestational age, birth weight, maternal age, weight, OFC, length, sex, mode of delivery matched, there was statistically non significant difference in APGAR score at ١ and ٥ minutes, gravidity and cause of prematurity between cases at ٣٦ weeks and controls, statistically non significant difference in CBC, CRP, mode of ventilation and outcome between cases at ٣٦ weeks and controls. Statistically significant shorter length of stay detected among cases compared to controls, there was statistically non significant difference in electrographic seizures activity and conventional EEG grade between cases at ٣٦ weeks and controls, statistically significant higher aEEG score (indicating better maturation) was detected in cases, compared to controls. |