title: Amplitude-integrated electroencephalography shows that doxapram influences the brain activity of preterm infants.
abstract: OBJECTIVE
  The aim of this study was to measure the brain activity of preterm infants treated with caffeine citrate and doxapram for preterm apnoea, using amplitude-integrated electroencephalography (aEEG), to identify any adverse effects on cerebral function.
  
  
  METHODS
  We analysed the aEEG tracings of 13 preterm infants <30 weeks of gestation before, during and after doxapram treatment, with regard to background activity (percentages of continuous and discontinuous patterns), occurrence of sleep-wake cycling and appearance of electrographic seizure activity. They were also compared with 61 controls without doxapram treatment.
  
  
  RESULTS
  During doxapram treatment, aEEG tracings showed an increase in continuous background activity (19 ± 30% before treatment, 38 ± 35% during treatment) and a decrease in discontinuous patterns. In addition, they showed more frequent electrographic seizure activity (0% before treatment, 15 ± 37% during treatment) and less frequent sleep-wake cycling (92 ± 27% before treatment, 85 ± 37% during treatment) could be observed. These results were confirmed when compared to the control group.
  
  
  CONCLUSIONS
  Doxapram treatment influences aEEG in preterm infants, showing higher percentages of continuous activity as well as more electrographic seizure activity and less sleep-wake cycling. It should, therefore, be used with caution in very preterm infants.
authors.affiliation: Division of Neonatology, Intensive Care and Neuropediatrics, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.
authors.forename: Christine
authors.initials: C
authors.lastname: Czaba-Hnizdo
authors.forename: Monika
authors.initials: M
authors.lastname: Olischar
authors.forename: Zsofia
authors.initials: Z
authors.lastname: Rona
authors.forename: Manfred
authors.initials: M
authors.lastname: Weninger
authors.forename: Angelika
authors.initials: A
authors.lastname: Berger
authors.forename: Katrin
authors.initials: K
authors.lastname: Klebermass-Schrehof
mesh_terms: D001049:Apnea / Q000188:drug therapy; D001921:Brain / Q000187:drug effects* / Q000502:physiology*; D004315:Doxapram / Q000494:pharmacology* / Q000627:therapeutic use; D004569:Electroencephalography / Q000187:drug effects* / Q000379:methods*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy; D008297:Male; D019141:Respiratory System Agents / Q000494:pharmacology* / Q000627:therapeutic use; D012189:Retrospective Studies
chemical_list: D019141:Respiratory System Agents; D004315:Doxapram
keywords: Amplitude-integrated electroencephalography; Brain activity; Doxapram; Preterm infant; Seizure activity