309 EFFECT OF CAFFEINE ON CONTROL OF BREATHING IN NEAR-MISS SUDDEN INFANT DEATH SYNDROME (SIDS)

Abstract

Abnormalities in control of breathing have been associated with near-miss SIDS. Since caffeine (C) is a respiratory stimulant, its effect on breathing pattern was evaluated in 12 infants with near-miss SIDS. Mean birth weights (±SE), gestational and postnatal age were 3.1±3.0 kg, 37.0±1.1 wks, and 7.9±1.7 wks, respectively. Ventilatory responses were measured with a face mask attached to a pneumotachometer to measure flow and integrated to yield volume before and 1 hour after caffeine citrate (20 mg/kg IV). Analysis of data before and after caffeine shows a significant increase in ventilation (Mean ±SE = 350.1±42.7 to 444.2±39.3 ml/kg/min, p<0.005); tidal volume (6.8±0.6 to 8.4±0.8 ml/kg, p<0.005) and mean inspiratory flow (V_T/T_I = 12.2 ± 1.2 to 15.9±1.2 ml/kg/sec, p = 0.001). In contrast, no changes were noted in inspiratory time (T_I), expiratory time or total cycle curation. These effects were observed with plasma concentrations of (C) (measured by HPLC) ranging from 8 to 20 mg/1. Data suggest that caffeine increases ventilation mainly by increasing central inspiratory drive and not by effective timing (T_I/T_TOT) and suggest possible efficacy of caffeine in near-miss SIDS.

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