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International Journal of Pediatrics
Volume 2013 (2013), Article ID 251047, 5 pages
http://dx.doi.org/10.1155/2013/251047
Clinical Study

Doxapram Use for Apnoea of Prematurity in Neonatal Intensive Care

1Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, J6-S, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
2Division of Neonatology, Department of Pediatrics, VU University Medical Center, Amsterdam, The Netherlands
3Division of Neonatology, Department of Pediatrics, Erasmus MC Sophia Children’s Hospital, Rotterdam, The Netherlands

Received 18 April 2013; Revised 6 October 2013; Accepted 10 October 2013

Academic Editor: Namık Yaşar Özbek

Copyright © 2013 S. A. Prins et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Apnoea of prematurity is treated with noninvasive respiratory therapy and methylxanthines. For therapy unresponsive apnoea doxapram is often prescibed in preterm neonates. The duration, dosage and route of administration of doxapram together with its efficacy was evaluated in two Dutch neonatal intensive care. Outcome concerning short-term safety and neonatal morbidity were evaluated. During 5 years, 122 of 1,501 admitted newborns <32 weeks of gestational age received doxapram. 64.8% of patients did not need intubation after doxapram. 25% of treated neonates were <27 weeks of gestation. A positive response to doxapram therapy on apnoea was associated with longer duration of doxapram usage ( ), lower mean doses ( ), and less days of intensive care (median 33 versus 42 days; ). No patients died during doxapram therapy. Incidence of necrotizing enterocolitis, intraventricular hemorrhage, periventricular leukomalacia, retinopathy of prematurity, persistent ductus arteriosus, or worsening of pulmonary condition did not increase during doxapram therapy. Doxapram is frequently used for apnoea of prematurity, despite a lack of data on short-term efficacy and long-term safety. Until efficacy and safety are confirmed in prospective trials, doxapram should be used with caution.