Abstract
Doxapram (Dx), a central respiratory stimulant has been reported to reduce neonatal apnea. To further assess the action and efficacy of Dx, we studied 8 infants with apnea refractory to Aminophylline at serum levels of 50 - 108 umol/l. Airway occlusions and measures of minute ventilation were performed 1 hr prior and 3 & 24 hr following Dx at a dose of 2.5 mg/kg/hr IV. No loading dose was given. Apnea frequency and duration as determined by continuous cardiorespirography, decreased within 6 hr. Minute ventilation increased, due to an increase in Vt, within 3 hr of Dx infusion, the increase in Ve becoming statistically significant by 24 hr. No changes in Ti, Te or Ttot were observed. P0.1 and Vt/Ti were significantly increased following 24 hr of Dx therapy.
Six infants' blood pressure increased with Dx therapy, in one severely enough to necessitate stopping Dx. Dx increases ventilation and respiratory centre output similar to effects observed with aminophylline and caffeine, indicating that respiratory centre output can be further increased even in the presence of adequate levels of xanthines. The observed hypertension suggests that further studies are necessary before the routine usage of Dx in neonates.
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Barrington, K., Finer, N. & Peters, K. 345 MECHANISMS OF ACTION OF DOXAPRAM IN NEONATAL APNEA. Pediatr Res 19, 168 (1985). https://doi.org/10.1203/00006450-198504000-00375
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DOI: https://doi.org/10.1203/00006450-198504000-00375