Efeitos da cafeína sobre o traçado eletroencefalográfico de recém nascidos prematuros

• Ano de defesa: 2017
• Autor(a) principal: Marx, Catherine [UNIFESP]
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Premature new born; Caffeine; Apnea; Electroencephalogram; Recém-nascido prematuro; Cafeína; Apnéia; Eletroencefalograma
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5085284; http://repositorio.unifesp.br/handle/11600/50037

Objective: To evaluate poligraphic traces of preterm newborns (PTNB) in use of caffeine and compare them to PTNB not in use of this medication, in terms of amount of epileptic discharges and/or seizures. Evaluate cerebral base activity (CBA) as well, including different age groups, taking into account total cumulative dose of caffeine (TCD) up to the day EEG was performed, and time of treatment initiation (early treatment introduction, up to the second day of life, or latte introduction, from the third day on). Method: If no apparent risks for seizures and/or epileptic discharges were present, not even abortive seizures drugs were in use, all PTNB born at Hospital São Paulo were considered into the study. Information about the patient, the mother, gestational inquiries, familiar and pathological conditions were assembled on questionnaires applied. Once the newborn suited the study profile, the baby was submitted to polygraph examination for at least 60 minutes with simultaneous video recording. EEG traces were subsequently analyzed in view of the presence of seizures and/or epileptic discharges and CBA differences. Results: At the end of almost two years of research, 117 patients were enrolled, 91 were embraced according to inclusion and exclusion criteria’s for analysis. Total cumulative dose of caffeine did not increase epileptic discharges and/or seizures. However, late caffeine treatment initiation established greater association to epileptic discharges frequency then early treatment. Considering CBA, babies on caffeine had altered synchronicity according to different corrected ages and time of treatment introduction. In addition, sleep disturbance could be detected on babies on caffeine, which presented a reduction on the percentage of total quiet sleep time and, therefore, interbusrts intervals were also affected. Conclusion: Different caffeine total cumulative doses does not predict seizures and/or epileptic discharges increases, however there seems to be a better chance of epileptic discharges on those PTNB that received late caffeine treatment introduction. Besides, it alters brain synchronicity and sleep structure, shortening quiet sleep and consequently interbusts intervals. Somehow, those results imply an interference on brain maturation.