Doxapram Use for Apnoea of Prematurity in Neonatal Intensive Care
Doxapram Use for Apnoea of Prematurity in Neonatal Intensive Care
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多沙普仑在新生儿重症监护中用于治疗早产儿呼吸暂停
DOI：
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发表时间：
2013
影响因子：
2.1
通讯作者：
S. Simons
中科院分区：
文献类型：
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作者：
S. Prins;S. Pans;M. van Weissenbruch;F. Walther;S. Simons
早产儿呼吸暂停的治疗与非侵入性呼吸治疗和甲基黄嘌呤。对于治疗无反应的呼吸暂停，多沙普仑通常用于早产儿。在两个荷兰新生儿重症监护的持续时间，剂量和途径的多沙普仑连同其疗效进行了评价。对短期安全性和新生儿发病率进行了评价。在5年的时间里，1,501名胎龄<32周的新生儿中有122名接受了多沙普仑治疗。64.8%的患者使用多沙普仑后无需插管。接受治疗的新生儿中有25%的妊娠期<27周。多沙普仑治疗对呼吸暂停的积极反应与多沙普仑使用时间较长（P < 0.001）、平均剂量较低（P < 0.003）和重症监护天数较少（中位数33天对42天; P < 0.002）相关。多沙普仑治疗期间无患者死亡。多沙普仑治疗期间，坏死性小肠结肠炎、脑室内出血、脑室周围白质软化、早产儿视网膜病变、动脉导管持续存在或肺部疾病恶化的发生率并未增加。多沙普仑经常用于早产儿呼吸暂停，尽管缺乏短期疗效和长期安全性的数据。在前瞻性试验中确认疗效和安全性之前，应谨慎使用多沙普仑。
Apnoea of prematurity is treated with noninvasive respiratory therapy and methylxanthines. For therapy unresponsive apnoea doxapram is often prescibed in preterm neonates. The duration, dosage and route of administration of doxapram together with its efficacy was evaluated in two Dutch neonatal intensive care. Outcome concerning short-term safety and neonatal morbidity were evaluated. During 5 years, 122 of 1,501 admitted newborns <32 weeks of gestational age received doxapram. 64.8% of patients did not need intubation after doxapram. 25% of treated neonates were <27 weeks of gestation. A positive response to doxapram therapy on apnoea was associated with longer duration of doxapram usage (P < 0.001), lower mean doses (P < 0.003), and less days of intensive care (median 33 versus 42 days; P < 0.002). No patients died during doxapram therapy. Incidence of necrotizing enterocolitis, intraventricular hemorrhage, periventricular leukomalacia, retinopathy of prematurity, persistent ductus arteriosus, or worsening of pulmonary condition did not increase during doxapram therapy. Doxapram is frequently used for apnoea of prematurity, despite a lack of data on short-term efficacy and long-term safety. Until efficacy and safety are confirmed in prospective trials, doxapram should be used with caution.