Doxapram for the initial treatment of idiopathic apnea of prematurity.

The ventilatory effects of doxapram in the initial pharmacotherapy for apnea in the newborn were evaluated in 8 premature infants with idiopathic apnea. All received doxapram for 48 h at 0.25 mg/kg/h on the first day and 1 mg/kg/h on the second day. The ventilatory effects and the airway occlusion pressure (p0.1) were measured by means of a face mask, and a pneumotachograph. Compared to the pretreatment period, the mean of the frequency of central apnea greater than or equal to 15 s decreased significantly (p less than 0.01) by 48 and 75% during the first and second day, respectively. Both doses significantly increased inspiratory drive measured by airway occlusion pressure by 20% (p less than 0.05) and 32% (p less than 0.01) on the first and second day of drug treatment, respectively. Minute ventilation, tidal volume and mean respiratory flow significantly increased only with 1 mg/kg/h of doxapram, accompanied by a significant decrease in transcutaneous PCO2. No side effects were noted. Data suggested that doxapram alone at a dose of 1 mg/kg/h is effective for the treatment of neonatal apnea.