Abstract | AIM: 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 (S(P)O(2)), 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 (S(P)O(2) </=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.
|
Authors | C F Poets, S Darraj, B Bohnhorst |
Journal | Biology of the neonate
(Biol Neonate)
Vol. 76
Issue 4
Pg. 207-13
(Oct 1999)
ISSN: 0006-3126 [Print] Switzerland |
PMID | 10473894
(Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)
|
Chemical References |
- Respiratory System Agents
- Caffeine
- Doxapram
- Oxygen
|
Topics |
- Apnea
(prevention & control)
- Birth Weight
- Bradycardia
(prevention & control)
- Caffeine
(administration & dosage, blood, therapeutic use)
- Doxapram
(administration & dosage, adverse effects, therapeutic use)
- Drug Resistance
- Gestational Age
- Humans
- Hypoxia
(prevention & control)
- Infant, Newborn
- Infant, Premature
- Infant, Premature, Diseases
(prevention & control)
- Infusions, Intravenous
- Intubation, Gastrointestinal
- Oxygen
(blood)
- Respiratory System Agents
(administration & dosage, adverse effects, therapeutic use)
|