Cafeína para recém-nascidos pré-termo: revisão narrativa
DOI:
https://doi.org/10.25753/BirthGrowthMJ.v32.i4.27860Palavras-chave:
apneia da prematuridade, cafeína, displasia broncopulmonar, farmacologia, metilxantina, recém-nascido pré-termoResumo
A cafeína é um antagonista do recetor de adenosina usado para prevenir ou tratar a apneia da prematuridade no período neonatal e é atualmente o tratamento de eleição em recém-nascidos de muito baixo peso. A cafeína é um estimulante amplamente utilizado, que demonstrou reduzir a duração da ventilação mecânica e da oxigenoterapia a curto prazo, para além das taxas de tratamento da persistência do canal arterial e da displasia broncopulmonar. A longo prazo, melhora o fluxo expiratório e associa-se a benefícios respiratórios. Estes resultados devem-se a vários efeitos da cafeína, nomeadamente estimulação do centro respiratório no tronco cerebral e melhoria da contratilidade diafragmática, proteção contra a inflamação pulmonar causada pela corioamnionite pró-inflamatória induzida por lipopolissacarídeos e efeitos diretos nos pneumócitos e na angiogénese pulmonar, reduzindo a lesão pulmonar induzida por hiperóxia. Para além disso, possui atividade antifibrótica no tecido pulmonar. A cafeína associa-se a uma melhoria da sobrevida sem alterações do neurodesenvolvimento aos 18 meses e segurança a longo prazo até os 11 anos de idade.
Neste artigo, é feita uma revisão não exaustiva de informação útil sobre um dos medicamentos mais utilizados em medicina neonatal.
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