2.50
Hdl Handle:
http://hdl.handle.net/10755/158309
Type:
Presentation
Title:
Salivary sampling for caffeine levels in preterm infants
Abstract:
Salivary sampling for caffeine levels in preterm infants
Conference Sponsor:Western Institute of Nursing
Conference Year:2003
Author:LaMar, Kim
P.I. Institution Name:Arizona State University, College of Nursing
Title:Faculty
Contact Address:Community Services Building, 200 East Curry Road, Tempe, AZ, 85287, USA
Statement of problem: Salivary drug sampling for therapeutic monitoring is a non-invasive technique for measuring drug concentrations. Saliva may be obtained at resting stage or by stimulating salivary glands. Caffeine is a metabolite of theophylline, a historical treatment for apnea of prematurity (AOP). Caffeine citrate (Cafcit) is now available commercially for the treatment of AOP. Managing AOP with caffeine involves the monitoring of caffeine levels to assess efficacy of the therapy. Monitoring of salivary caffeine concentrations following stimulation of salivary secretions has been studied using caffeine citrate preparations. This study examined the relationship between serum and salivary caffeine concentrations in preterm infants on caffeine citrate for treatment of AOP without using stimulation techniques to increase salivary production. Research design: A prospective, descriptive correlational design examining the relationship between serum and saliva samples for measuring caffeine levels in preterm infants diagnosed with AOP. Sample: Convenience sampling was used to enroll infants admitted to the neonatal intensive care unit (NICU) at less than 33 weeks gestation who were diagnosed with AOP that was treated with caffeine citrate. Methods: Preterm infants were identified and their parent(s) consented. Simultaneous serum and saliva samples were obtained at steady state after receiving a loading dose with caffeine base of 10mg/kg followed by maintenance dosing (MD) at 2.5mg/kg/day both as caffeine citrate preparations. Caffeine content was determined using high performance liquid chromatography. Results: The relationship between serum and salivary concentrations was evaluated using serum:saliva ratios and a regression model. 44 infants were enrolled with a mean gestational age and post conceptual age of 26.6 ± 2.1 and 33.07 ± 1.85 weeks, respectively and mean study weight 1.55 ± 0.37kg. The mean caffeine MD was 2.75 ± 0.7mg/kg/day. Mean serum and salivary caffeine concentrations were 11.1 ± 4 (N=44) and 8.7 ± 4.4 (N=34) mcg/ml, respectively. 28 serum:saliva pairs were available for regression analysis which produced an r value of 0.4 (p=0.036) and a mean saliva:serum ratio of 0.97 ± 0.4. 10 saliva samples were removed for insufficient sampling volume and another 6 for very low caffeine concentrations. Conclusion: A linear relationship exists between serum and salivary caffeine concentrations as indicated by regression analysis. Routine use of salivary caffeine concentration monitoring in clinical practice without the use of salivary stimulants depends upon expertise of personnel involved in such sampling and appropriate timing and handling of such samples.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleSalivary sampling for caffeine levels in preterm infantsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/158309-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Salivary sampling for caffeine levels in preterm infants </td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2003</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">LaMar, Kim</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Arizona State University, College of Nursing</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Faculty</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">Community Services Building, 200 East Curry Road, Tempe, AZ, 85287, USA</td></tr><tr><td colspan="2" class="item-abstract">Statement of problem: Salivary drug sampling for therapeutic monitoring is a non-invasive technique for measuring drug concentrations. Saliva may be obtained at resting stage or by stimulating salivary glands. Caffeine is a metabolite of theophylline, a historical treatment for apnea of prematurity (AOP). Caffeine citrate (Cafcit) is now available commercially for the treatment of AOP. Managing AOP with caffeine involves the monitoring of caffeine levels to assess efficacy of the therapy. Monitoring of salivary caffeine concentrations following stimulation of salivary secretions has been studied using caffeine citrate preparations. This study examined the relationship between serum and salivary caffeine concentrations in preterm infants on caffeine citrate for treatment of AOP without using stimulation techniques to increase salivary production. Research design: A prospective, descriptive correlational design examining the relationship between serum and saliva samples for measuring caffeine levels in preterm infants diagnosed with AOP. Sample: Convenience sampling was used to enroll infants admitted to the neonatal intensive care unit (NICU) at less than 33 weeks gestation who were diagnosed with AOP that was treated with caffeine citrate. Methods: Preterm infants were identified and their parent(s) consented. Simultaneous serum and saliva samples were obtained at steady state after receiving a loading dose with caffeine base of 10mg/kg followed by maintenance dosing (MD) at 2.5mg/kg/day both as caffeine citrate preparations. Caffeine content was determined using high performance liquid chromatography. Results: The relationship between serum and salivary concentrations was evaluated using serum:saliva ratios and a regression model. 44 infants were enrolled with a mean gestational age and post conceptual age of 26.6 &plusmn; 2.1 and 33.07 &plusmn; 1.85 weeks, respectively and mean study weight 1.55 &plusmn; 0.37kg. The mean caffeine MD was 2.75 &plusmn; 0.7mg/kg/day. Mean serum and salivary caffeine concentrations were 11.1 &plusmn; 4 (N=44) and 8.7 &plusmn; 4.4 (N=34) mcg/ml, respectively. 28 serum:saliva pairs were available for regression analysis which produced an r value of 0.4 (p=0.036) and a mean saliva:serum ratio of 0.97 &plusmn; 0.4. 10 saliva samples were removed for insufficient sampling volume and another 6 for very low caffeine concentrations. Conclusion: A linear relationship exists between serum and salivary caffeine concentrations as indicated by regression analysis. Routine use of salivary caffeine concentration monitoring in clinical practice without the use of salivary stimulants depends upon expertise of personnel involved in such sampling and appropriate timing and handling of such samples. </td></tr></table>en_GB
dc.date.available2011-10-26T20:43:04Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:43:04Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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