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EFFECTS OF CAFFEINE AND/OR NASAL CPAP TREATMENT ON LARYNGEAL CHEMOREFLEXES IN PRETERM LAMBS.
MedLine Citation:
PMID:  23305977     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Current knowledge suggests that laryngeal chemoreflexes (LCR) are involved in the occurrence of certain neonatal apneas/bradycardias, especially in the preterm newborn. While caffeine and/or nasal continuous positive airway pressure (nCPAP) are the most frequent options used for treating apneas in preterm newborns, their effects on LCR-related apneas/bradycardias are virtually unknown. The aim of the present study was to test the hypothesis that caffeine and/or nCPAP decreases LCR-related cardiorespiratory inhibition in a preterm ovine model. Seven preterm lambs were born vaginally on gestational day 133 (normal gestation: 147 days) after intramuscular injections of betamethasone and mifepristone. Five days after birth, a chronic surgical instrumentation was performed to record states of alertness, electrocardiogram, systemic arterial pressure and electromyographic activity of a laryngeal constrictor muscle as well as to insert a transcutaneous, supraglottal catheter. Laryngeal chemoreflexes were induced in quiet sleep during 4 conditions: 1) control (without caffeine or nCPAP); 2) nCPAP (5 cm H(2)O, without caffeine); 3) caffeine (10mg/kg infused intravenously in 30 minutes, without nCPAP); and 4) nCPAP + caffeine. Our results showed that nCPAP consistently blunted the LCR-related cardiorespiratory inhibition vs. control condition, contrary to caffeine whose overall effect was non significant. In addition, nCPAP condition was characterized by both a more consistent and rapid arousal after HCl injection. No significant differences were observed between all tested with regards to swallowing and cough. It is concluded that nCPAP should be further assessed for its usefulness in treating neonatal apneas linked to LCR.
Authors:
Nadia Boudaa; Nathalie Samson; Vincent Carrière; Pamela Samanta Germim; Jean-Charles Pasquier; Aida Bairam; Jean-Paul Praud
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-10
Journal Detail:
Title:  Journal of applied physiology (Bethesda, Md. : 1985)     Volume:  -     ISSN:  1522-1601     ISO Abbreviation:  J. Appl. Physiol.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8502536     Medline TA:  J Appl Physiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1Université de Sherbrooke.
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