Effect of doxapram on postoperative pulmonary complications after upper abdominal surgery in high-risk patients

Surgery and the respiratory muscles

“…Recently, a number of drugs and physical manoeuvres have been tested in order to reverse this inhibition. Jansen et al 69 showed that doxapram, a primary stimulant of respiration (central), reduced the incidence of postoperative pulmonary complications and increased oxygenation after upper abdominal surgery. In addition, Siafakas et al 60 showed in a double blind study that aminophylline had a protective effect on respiratory muscle function against phrenic nerve inhibition after upper abdominal surgery.…”

Outcomes of Patients With Acute Respiratory Failure After Abdominal Surgery Treated With Noninvasive Positive Pressure Ventilation

“…[3][4][5][6] The reduction in diaphragmatic activity contributes to lower-lobe atelectasis and other respiratory complications. 7 Most often, the management of ARF in patients after abdominal surgery admitted to the ICU re-quires endotracheal intubation and mechanical ventilation (MV). Furthermore, ARF with the need of endotracheal intubation and MV are independent predictors of hospital mortality.…”

One-Lung Anesthesia Update

“…Doxapram, a central nervous system stimulant, has been found to reduce postoperative pulmonary complications 67 and improve oxygenation during the first 5 days after major abdominal surgery. 68 A study evaluating the efficacy of doxapram administered postoperatively via continuous infusion was terminated early after 3 of the 9 patients receiving the stimulant developed complications, including brain stem infarction. 69 Patients exhibiting signs of hypoxemia secondary to alveolar hypoventilation readily respond to supplemental oxygen therapy, 70 but normalization of the PACO 2 by improving alveolar ventilation should be the principal goal of patient management.…”