Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
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.

PubMed Disclaimer

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

References

    1. Eichenwald EC, Committee on Fetus and Newborn, American Academy of Pediatrics Apnea of Prematurity. Pediatrics. 2016 Jan;137((1)):e20153757. - PubMed
    1. Hascoet JM, Hamon I, Boutroy MJ. Risks and benefits of therapies for apnoea in premature infants. Drug Saf. 2000 Nov;23((5)):363–79. - PubMed
    1. Yost CS. A new look at the respiratory stimulant doxapram. CNS Drug Rev. 2006;12((3-4)):236–49. - PMC - PubMed
    1. Flint R, Halbmeijer N, Meesters N, van Rosmalen J, Reiss I, van Dijk M, et al. Retrospective study shows that doxapram therapy avoided the need for endotracheal intubation in most premature neonates. Acta Paediatr. 2017 May;106((5)):733–9. - PubMed
    1. Barrington KJ, Finer NN, Peters KL, Barton J. Physiologic effects of doxapram in idiopathic apnea of prematurity. J Pediatr. 1986 Jan;108((1)):124–9. - PubMed

Publication types