All issues > Volume 38(8); 1995

Original Article

J Korean Pediatr Soc. 1995;38(8):1046-1053. Published online August 15, 1995.

Doxapram in the Treatment of Idiopathic Apnea of Prematurity Unresponsive to Aminophylline

Jung Hoon JH Park¹, Hee Sup HS Kim¹, Sang Hee SH Kim¹, Gil Hyun GH Kim¹, Hak Soo HS Lee¹

¹Department of Pediatrics, Chung Ang Gil Hospital, Incheon, Korea

Abstract

Purpose
: Recurrent apnea of prematurity is a very common and troublesome problem despite treatment with aminophylline, and is often associated with a poor developmental outcome. Recently doxapram, a potent respiratory stimulant in adults, has been used to overcome idiopathic apnea of prematurity. This study was to evaluate the efficacy, safety and optimal dosage of doxapram in idiopathic apnea refractory to aminophylline.
Methods
: Twenty premature infants less than 32 weeks of gestational age with idiopathic apnea refractory to therapeutic levels of aminophylline were divided into 2 groups as control and study group. Continuous treatment with aminophylline was done in control group, whereas doxapram was infused with maintenance dose of aminophylline in study group refractory to aminophylline alone. Doxapram was given initially with 0.5mg/kg/h for 48 hours and could be repeated with increment of 0.5mg/kg/h, maximally to 1.5mg/kg/h when there had been no response.
Results
: 1) There were no statistical differences between control and study group in gestational age(30.4±0.2weeks vs 30±1.3weeks), birth weight(1.54±0.2kg vs 1.46±0.3kg) and serum theophylline level at 12hours after treatment with aminophylline(8.8±1.1㎍/ml vs 9.1±1.5㎍/ml). 2) Frequency of apnea(episodes/8hours) was significantly decreased to 1.9±2.0 in study group which was treated with doxapram and aminophylline, compared with 3.4±1.5 episodes in control group treated with aminophylline alone(p<0.05). 3) The mean highest dosage of effectiveness in doxapram was 0.8±0.4mg/kg/h and the mean duration of treatment with doxapram was 3.2±1.6 days. 4) Ventilator care was needed for 3 cases in control group and 1 case in study group, which had been refractory to each treatments. 5) Irritability was observed in 2 cases with dosage of 1.5mg/kg/h and disappeared after the cessation of infusion.
Conclusion
: Low-dose doxapram is effective in idiopathic apnea of prematurity and it could be safely used without significant adverse effects by slow increment of dosage.

Keywords :Doxapram, Aminophylline, Idiopathic apnea, Prematurity