Effect of doxapram on episodes of apnoea, bradycardia and hypoxaemia in preterm infants.

Abstract

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 (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)