title: Retrospective study shows that doxapram therapy avoided the need for endotracheal intubation in most premature neonates.
abstract: OBJECTIVE
  Using doxapram to treat neonates with apnoea of prematurity might avoid the need for endotracheal intubation and invasive ventilation. We studied whether doxapram prevented the need for intubation and identified the predictors of the success.
  
  
  METHODS
  This was a retrospective study of preterm infants born from January 2006 to August 2014 who received oral or intravenous doxapram. Success was defined as no need for endotracheal intubation, due to apnoea, during doxapram therapy. Univariable and multivariable logistic regression analyses identified predictors of success during the first 48 hours of doxapram therapy.
  
  
  RESULTS
  Data on 203 patients with a median gestational age of 26.1 (interquartile range 25.1-27.4) weeks were analysed. During the first 48 hours of doxapram therapy, 157 (77%) patients did not need endotracheal intubation and 127 (63%) patients were successfully treated over the entire treatment course. The median postnatal age at the start of doxapram therapy was 20 days (interquartile range 12-30). Postnatal age and a lower fraction of inspired oxygen at the start of doxapram therapy were significant predictors of success (odds ratio 0.964, 95% confidence interval 0.938-0.991, p = 0.001).
  
  
  CONCLUSIONS
  Oral and intravenous doxapram effectively treated most cases of apnoea in preterm infants, avoiding the need for intubation.
authors.affiliation: Division of Neonatology, Department of Paediatrics, Erasmus University Medical Centre - Sophia Children's Hospital, Rotterdam, The Netherlands.|Department of Pharmacy, Radboudumc, Nijmegen, The Netherlands.|Department of Pharmacy, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors.forename: Robert
authors.initials: R
authors.lastname: Flint
authors.affiliation: Division of Neonatology, Department of Paediatrics, Erasmus University Medical Centre - Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: Nienke
authors.initials: N
authors.lastname: Halbmeijer
authors.affiliation: Division of Neonatology, Department of Paediatrics, Erasmus University Medical Centre - Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: Naomi
authors.initials: N
authors.lastname: Meesters
authors.affiliation: Department of Biostatistics, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors.forename: Joost
authors.initials: J
authors.lastname: van Rosmalen
authors.affiliation: Division of Neonatology, Department of Paediatrics, Erasmus University Medical Centre - Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: Irwin
authors.initials: I
authors.lastname: Reiss
authors.affiliation: Division of Neonatology, Department of Paediatrics, Erasmus University Medical Centre - Sophia Children's Hospital, Rotterdam, The Netherlands.|Department of Paediatric Surgery, Erasmus University Medical Centre - Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: Monique
authors.initials: M
authors.lastname: van Dijk
authors.affiliation: Division of Neonatology, Department of Paediatrics, Erasmus University Medical Centre - Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: Sinno
authors.identifier: http://orcid.org/0000-0001-5219-5696
authors.initials: S
authors.lastname: Simons
mesh_terms: D001049:Apnea / Q000188:drug therapy*; D004315:Doxapram / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data*; D008297:Male; D019141:Respiratory System Agents / Q000627:therapeutic use*; D012189:Retrospective Studies
chemical_list: D019141:Respiratory System Agents; D004315:Doxapram
keywords: Apnoea; Doxapram; Intubation; Predictors; Prematurity