Prematüre Apnesinde Kafein Tedavisi: Geleneksel Derleme.

Apnea of prematurity is a frequently encountered condition in premature infants in the neonatal-intensive-care-units and is defined as respiratory arrest for more than 15-20 seconds or short-term respiratory interruption accompanied by low oxygen-saturation and/or bradycardia. While apnea is observed in almost all babies born below 28 weeks of gestation, the frequency of apnea decreases as the gestational week gets older. Hypoxemia and bradycardia attacks intervening due to apnea together with the neurological immaturity caused by premature-birth increase the risk of neurological damage in these babies and in the long term; it can cause significant morbidities such as cerebral palsy, developmental coordination disorder, cognitive and behavioral disorders, bronchopulmonary dysplasia, and retinopathy of prematurity. For this reason, the diagnosis and treatment of apnea in premature infants is important, and caffeine, a methylxanthine derivative, is the first choice in the pharmacological treatment of apnea. Caffeine is structurally similar to adenosine and its effect is dose-dependent mainly on adenosine receptors. Caffeine eliminates the inhibition of the medullary-respiratory-center suppressed by adenosine in apnea of prematurity, increases neural excitation by preventing gamma-aminobutyric acid release, increases the sensitivity of the central nervous system to blood carbon-dioxide levels, thus it stimulates and maintains respiration in infants with apnea. In this review, the effect of caffeine, which is the first choice in the treatment of apnea in premature infants, information about who, when, in which dose, and for how long we should use it, has been tried to be given in the light of the recent literature data. [ABSTRACT FROM AUTHOR]