Doxapram treatment for apnea in preterm infants

Amplitude‐integrated electroencephalography shows that doxapram influences the brain activity of preterm infants

“…Although intravenous doxapram therapy reduces apnoea of prematurity, up to now few data have specified this effect and assessed the potential adverse effects on short‐term and long‐term outcome .…”

“…Methylxanthines such as caffeine citrate are used as the first‐line treatment for apnoeas in preterm infants. In addition, doxapram has been used to treat apnoea of prematurity refractory to methylxanthine derivates .…”

Comparative effects of respiratory stimulants on hypoxic neuronal cell injury in SH‐SY5Y cells and in hippocampal slice cultures from rat pups

“…Caffeine is mainly used as first‐line treatment in Europe and the USA, while in Japan, theophylline is approved, caffeine is not approved, and doxapram is contraindicated. The effectiveness of caffeine, theophylline, and doxapram seems to be comparable in the short‐term treatment of AOP . There is currently a need, however, for differentiation of AOP therapeutic agents, taking into account not only the alleviation of apnea but also adverse reactions, secondary benefits to infant patients, and so forth.…”

“…Appropriate respiratory support is essential in AOP, because apnea‐induced hypoxia can cause damage to the developing brain . Respiratory stimulants, such as caffeine, theophylline, and doxapram, have been used for patients with AOP, and therapeutic benefits, such as reduced frequency of apnea episodes and shorter periods of artificial respiration have been shown in clinical trials . A large, randomized, controlled trial among very low‐birthweight infants showed a significant decrease in the rate of bronchopulmonary dysplasia in the caffeine‐treated group, with a low incidence of short‐term toxicity .…”

Effect of Doxapram on Cerebral Blood Flow Velocity in Preterm Infants

“…They have been used in clinical practice to stimulate breathing efforts and reduce apnea since the 1970s. Doxapram stimulates breathing and has been used as an alternative or additionally to methylxanthines [2,9,10]. In many neonatal units, doxapram is used to treat apnea of prematurity when other treatment options fail.…”