Low-dose doxapram for treatment of apnoea following early weaning in very low birthweight infants: a randomized, double-blind study.
The effects of low-dose doxapram (0.5 mg kg(-1)h(-1)) in combination with caffeine were evaluated on apnoea frequency following weaning from mechanical ventilation, and on blood pressure, in very low birthweight (BW) premature infants. Twenty-nine infants with BW < or=1250 g, gestational age at birth (GA) <34 weeks and postnatal age <5 d, who required minimal respiratory support, were included. Following randomization, they received a loading dose of caffeine citrate and a continuous infusion of doxapram (doxapram, n=14) or placebo (n=15) was started. They were extubated 8 h after starting the infusion, which was continued for 5 d. During this period, weaning was well tolerated in both groups, apnoeas occurred less frequently and there was a greater increase in systolic blood pressure in infants treated with doxapram than in controls. Plasma doxapram levels were also higher than expected. It is therefore suggested that doxapram, even at low doses, should not be used during the first few days of life. Careful monitoring of blood pressure is required if doxapram is used later.
Huon
C
C
Service de Médecine Néonatale de Port-Royal, Centre Hospitalier Universitaire Cochin Port-Royal, Université René Descartes, Paris, France.
Rey
E
E
Mussat
P
P
Parat
S
S
Moriette
G
G
D001049:Apnea / Q000188:drug therapy*; D001794:Blood Pressure / Q000187:drug effects; D002110:Caffeine / Q000627:therapeutic use; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D004311:Double-Blind Method; D004315:Doxapram / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007262:Infusions, Intravenous; D019141:Respiratory System Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome; D015300:Ventilator Weaning
D000697:Central Nervous System Stimulants; D019141:Respiratory System Agents; D002110:Caffeine; D004315:Doxapram