Dynamic QT/RR relationship of cardiac conduction in premature infants treated with low-dose doxapram hydrochloride

Miyata, Masafumi; Hata, Tadayoshi; Kato, Noriko; Takeuchi, Masatomo; Mizutani, Hiromichi; Kubota, Masamichi; Yamazaki, Toshio

doi:10.1515/jpm.2007.068

Cited by 14 publications

(16 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In addition, 130 studies were excluded for the reasons mentioned in figure 1. This left 32 studies for the final analyses, 4 RCTs [13,14,15,16], 1 prospective crossover study [17], 2 case-control studies [18,19], and 25 cohort, case series or case reports studies [20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44]. Four studies were only available in abstract form [19,23,24,38].…”

Section: Resultsmentioning

confidence: 99%

“…Sixteen case series were included, reporting a total of 324 preterm infants treated with doxapram (table 1) [27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42]. One study was a pilot study described in a letter to the editor [29], and one study was only available in abstract form [38].…”

Section: Resultsmentioning

confidence: 99%

“…All studies reporting on apnea frequency showed a significant reduction after starting doxapram therapy [27,28,29,30,31,34,37,39,41,42]. Four of the 9 studies reporting on blood pressure showed hypertension in patients treated with a doxapram dose exceeding 1.5 mg·kg -1 ·h -1 (table 1) [30,31,32,42].…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Doxapram Treatment for Apnea of Prematurity: A Systematic Review

et al. 2016

View full text Add to dashboard Cite

Background: Apnea of prematurity (AOP) is a common complication of preterm birth, for which caffeine is the first treatment of choice. In case of persistent AOP, doxapram has been advocated as an additional therapy. Objective: To identify and appraise all existing evidence regarding efficacy and safety of doxapram use for AOP in infants born before 34 weeks of gestational age. Methods: All studies reporting on doxapram use for AOP were identified by searching electronic databases, references from relevant studies, and abstracts from the Societies for Pediatric Research. Two reviewers independently assessed study eligibility and quality, and extracted data on study design, patient characteristics, efficacy and safety outcomes. Results: The randomized controlled trials showed less apnea during doxapram treatment when compared to placebo, but no difference in treatment effect when compared to theophylline. No serious adverse effects were reported. We identified 28 observational studies consisting mainly of cohort studies and case series (n = 1,994). There was considerable heterogeneity in study design and quality. Most studies reported a positive effect of doxapram on apnea rate. A few studies reported on long-term outcomes with conflicting results. A range of possible doxapram-related short-term adverse effects were reported, sometimes associated with the use of higher doses. Conclusion: Based on the limited number of studies and level of evidence, no firm conclusions on the efficacy and safety of doxapram in preterm infants can be drawn. For this reason, routine use cannot be recommended. A large multicenter randomized controlled trial is urgently needed to provide more conclusive evidence.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Doxapram Treatment for Apnea of Prematurity: A Systematic Review

et al. 2016

View full text Add to dashboard Cite

show abstract

“…We have found that clinical doses of doxapram hydrochloride have no effect on the heart conduction system in rats [5], while doxapram hydrochloride at high doses prolongs the myocardial repolarization interval and causes deterioration of halothane adrenaline-induced arrhythmia. In this study, we focused on doxapram hydrochloride-induced bidirectional ventricular tachycardia (BVT) that is a rare entity occurring in conditions associated with intracellular calcium overload.…”

Section: Introductionmentioning

confidence: 99%

Doxapram Hydrochloride Aggravates Adrenaline-Induced Arrhythmias Accompanied by Bidirectional Ventricular Tachycardia

et al. 2014

Self Cite

View full text Add to dashboard Cite

Objectives. Doxapram hydrochloride is a respiratory stimulant that has an inhibitory effect on myocardial IK1 potassium channels and is thought to increase membrane instability and excitability in myocardial cells. We examined the arrhythmogenic effects of doxapram hydrochloride in a rat model of halothane adrenaline-induced arrhythmia. Methods. Thirteen female Wistar rats (12–14 weeks old) were used in the study. Animals were anesthetized with inhalation of halothane to permit observation of the effects of doxapram hydrochloride on halothane adrenaline-induced arrhythmia. Time-dependent changes in ECG repolarization characteristics (QT, QTc, JTp, JT, and Tp-e intervals) were studied. Results. Doxapram hydrochloride itself did not induce arrhythmia but did induce bidirectional ventricular tachycardia after addition of adrenaline. Conclusion. Drug-induced impairment of intracellular Ca2+ regulation caused BVT in the absence of genetic abnormalities in proteins in the sarcoplasmic reticulum.

show abstract

“…Although doxapram can reduce apnea in preterm infants, undesirable side‐effects, such as perforation of the digestive tract, mean that it requires caution at high doses . Recent studies, however, have demonstrated the efficacy and safety of doxapram therapy for AOP at lower doses than those previously tested . The safety and efficacy of respiratory stimulants are important topics in the treatment of AOP.…”

mentioning

confidence: 99%