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Observational Study
. 2019;115(1):85-88.
doi: 10.1159/000493359. Epub 2018 Oct 23.

Doxapram Treatment and Diaphragmatic Activity in Preterm Infants

Cornelia G de Waal  1 , Gerard J Hutten  2 , Juliette V Kraaijenga  2 , Frans H de Jongh  2 , Anton H van Kaam  2   3
Affiliations
Observational Study

Doxapram Treatment and Diaphragmatic Activity in Preterm Infants

Cornelia G de Waal et al. Neonatology. 2019.

Abstract

Background: Doxapram is a treatment option for severe apnea of prematurity (AOP). However, the effect of doxapram on the diaphragm, the main respiratory muscle, is not known.

Objectives: To investigate the effect of doxapram on diaphragmatic activity measured with transcutaneous electromyography of the diaphragm (dEMG).

Methods: A pilot study was conducted in a tertiary neonatal intensive care unit. Diaphragmatic activity was measured from 30 min before up to 3 h after the start of doxapram treatment. dEMG parameters were compared to baseline (5 min before doxapram treatment) and at 15, 60, 120 and 180 min after the start of doxapram infusion.

Results: Eleven preterm infants were included with a mean gestational age of 25.5 ± 1.2 weeks and birth weight of 831 ± 129 g. The amplitudedEMG, peakdEMG and tonicdEMG values did not change in the 3 h after the start of doxapram infusion compared to baseline. Clinically, the number of apnea episodes in the 24 h after doxapram treatment decreased significantly.

Conclusion: Doxapram infusion does not alter diaphragmatic activity measured with transcutaneous dEMG in preterm infants with AOP, indicating that its working mechanism is primarily on respiratory drive and not on respiratory muscle activity.

Keywords: Diaphragm; Doxapram; Transcutaneous electromyography.

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Figures

Fig. 1
Fig. 1
Percentage change in amplitudedEMG at baseline before doxapram and in the 3 h thereafter. Displayed are the median and interquartile range for each time point. dEMG, transcutaneous electromyography of the diaphragm; n, number of infants.
See this image and copyright information in PMC

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