Effect of Doxapram on Episodes of Apnoea, Bradycardia and Hypoxaemia in Preterm InfantsPoets C.F. · Darraj S. · Bohnhorst B.
Department of Neonatology and Paediatric Pulmonology, Hannover Medical School, Hannover, Germany
Do you have an account?
- Rent for 48h to view
- Buy Cloud Access for unlimited viewing via different devices
- Synchronizing in the ReadCube Cloud
- Printing and saving restrictions apply
Rental: USD 8.50
Cloud: USD 20.00
Aim: To study the effect of doxapram on the frequency of apnoea, bradycardia and hypoxaemia. Methods: Fifteen infants, median gestational age at birth 27 weeks (range 24–30), age at study 27 days (12–60), with ≥6 episodes of bradycardia or hypoxaemia/6 h despite serum caffeine levels in the therapeutic range, received doxapram either intravenously (0.5–2 mg/kg/h) or orally (2–8 mg/kg every 2 h). Six-hour recordings of pulse oximeter saturation (SPO2), pulse waveforms, ECG, breathing movements and nasal airflow were performed immediately before as well as 1, 3 and 6 days after onset of treatment. Recordings were analysed for apnoea (≥4 s), bradycardia (heart rate < 2/3 of baseline) and hypoxaemia (SPO2 ≤80%). Results: There was no difference between enteral and intravenous administration; results are therefore presented for the total group. Doxapram resulted in a significant decrease in the frequency of apnoea [22 (11–27) vs. 14 (7–23)/h, p < 0.01], bradycardia [3 (0–7) vs. 1 (0–3)/h, p < 0.01] and hypoxaemia [8 (0–18) vs. 2 (0– 17)/h, p < 0.01] already after 1 day of treatment, which was sustained throughout the 6-day study period. Side effects included an increase in the proportion of time spent awake [5 (0–24) vs. 12% (3–28), p < 0.01] and in gastric residuals [0% of feeding volume (0–5) vs. 4% (0–19), p < 0.05]. Enteral was switched to intravenous doxapram in 3 of 9 infants because of gastrointestinal side effects. Conclusion: Doxapram substantially reduced the frequency of apnoea, bradycardia and hypoxaemia in these patients with caffeine-resistant apnoea of prematurity. Enteral administration, however, was not tolerated in a significant proportion (33%) of infants.
Article / Publication Details
Copyright / Drug Dosage / DisclaimerCopyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.