Tomoyuki Shimokaze1, Katsuaki Toyoshima2, Jun Shibasaki2, Yasufumi Itani2. 1. Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, 232-8555, Japan. tkaze@hotmail.com. 2. Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, 232-8555, Japan.
Abstract
OBJECTIVE: We often encounter infants who developed hypokalaemia following low-dose doxapram for apnea of prematurity (AOP). AIMS: To determine changes in blood potassium (K+) levels after doxapram administration. STUDY DESIGN: We studied infants born before 30 weeks gestation. Doxapram (0.1-0.3 mg/kg/h) in addition to methylxanthines was used to treat AOP refractory to methylxanthines. RESULTS: Twenty-five infants received doxapram were studied. Fifty-two percent developed hypokalemia (<3.0 mEq/L) during doxapram administration. Time after starting doxapram to nadir blood K+ (<3.0 mEq/L) level was 11 days. Blood K+ levels normalized after 5 days of stopping doxapram administration. Data at 10 days before and after and at the time of doxapram administration were, respectively: lowest blood K+ level: 3.9, 3.0, and 3.6 mEq/L; urine aldosterone: 90, 206, and 146 pg/μg creatinine. Blood pH, blood pressure and urine volume were similar. CONCLUSIONS: Doxapram-induced hypokalemia may be due to an inappropriate increase in aldosterone levels.
OBJECTIVE: We often encounter infants who developed hypokalaemia following low-dose doxapram for apnea of prematurity (AOP). AIMS: To determine changes in blood potassium (K+) levels after doxapram administration. STUDY DESIGN: We studied infants born before 30 weeks gestation. Doxapram (0.1-0.3 mg/kg/h) in addition to methylxanthines was used to treat AOP refractory to methylxanthines. RESULTS: Twenty-five infants received doxapram were studied. Fifty-two percent developed hypokalemia (<3.0 mEq/L) during doxapram administration. Time after starting doxapram to nadir blood K+ (<3.0 mEq/L) level was 11 days. Blood K+ levels normalized after 5 days of stopping doxapram administration. Data at 10 days before and after and at the time of doxapram administration were, respectively: lowest blood K+ level: 3.9, 3.0, and 3.6 mEq/L; urine aldosterone: 90, 206, and 146 pg/μg creatinine. Blood pH, blood pressure and urine volume were similar. CONCLUSIONS:Doxapram-induced hypokalemia may be due to an inappropriate increase in aldosterone levels.
Authors: Jarinda A Poppe; Willem van Weteringen; Lotte L G Sebek; Catherijne A J Knibbe; Irwin K M Reiss; Sinno H P Simons; Robert B Flint Journal: Front Pharmacol Date: 2020-05-12 Impact factor: 5.810
Authors: Robert B Flint; Sinno H P Simons; Peter Andriessen; Kian D Liem; Pieter L J Degraeuwe; Irwin K M Reiss; Rob Ter Heine; Aline G J Engbers; Birgit C P Koch; Ronald de Groot; David M Burger; Catherijne A J Knibbe; Swantje Völler Journal: Pediatr Res Date: 2020-07-22 Impact factor: 3.756