Low-dose doxapram therapy for idiopathic apnea of prematurity

Background: Doxapram is contraindicated for newborn infants in Japan becaus e of its serious side effects. However, because of encouraging results of r ecent studies: regarding the efficacy and safety of therapy for apnea of pr ematurity (AOP) with lower doses of doxapram than those previously proposed , approximately 60% of Japanese neonatologists continue to use doxapram at small doses. Caution is warranted because the sample sizes of the former st udies are inadequate to evaluate doxapram for both its beneficial and harmf ul effects. Therefore, we conducted the present study in order to investiga te the efficacy and harmful events: of low-dose doxapram therapy for idiopa thic AOP in very low-birth weight (VLBW) infants: in a larger population. Methods: One hundred and six VLBW infants with idiopathic AOP were treated with doxapram at a dose of 0.2-1.0 mg/kg per h in combination with methylxa nthines and the frequency of apnea. and secondary outcomes were compared wi th a group of control infants. Results: An approximate 80% reduction in the frequency of apnea was found w ith only minimal side effects following low-dose doxapram. Although there w ere no significant differences in secondary outcomes between the doxapram-t reated and control groups, mortality in doxapram-treated infants was signif icantly lower than that in control infants. Conclusions: Patients with AOP unresponsive to treatment with methylxanthin es may benefit from the addition of low-dose doxapram.