Effect of doxapram on the electrical activity of the diaphragm waveform pattern of preterm infants.
bronchopulmonary dysplasia
neonatal intensive care units
respiratory system agents
Journal
Pediatric pulmonology
ISSN: 1099-0496
Titre abrégé: Pediatr Pulmonol
Pays: United States
ID NLM: 8510590
Informations de publication
Date de publication:
06 2022
06 2022
Historique:
revised:
01
03
2022
received:
05
02
2022
accepted:
04
03
2022
pubmed:
12
3
2022
medline:
21
5
2022
entrez:
11
3
2022
Statut:
ppublish
Résumé
This study aimed to evaluate the change in the waveform pattern of the electrical activity of the diaphragm (Edi) following the administration of doxapram in extremely preterm infants ventilated with neurally adjusted ventilatory assist (NAVA). We conducted this retrospective cohort study in our neonatal intensive care unit between November 2019 and September 2021. The study participants were extremely preterm infants under the gestational age of 28 weeks who were ventilated with NAVA and administered doxapram. We collected the data of the Edi waveform pattern and calculated the proportion. To analyze the change in the proportion of the Edi waveform pattern, we compared the proportion of the data for 1 h before and after doxapram administration. Ten extremely preterm infants were included. Almost all the patients' respiratory condition improved after doxapram administration. The ventilatory parameters-Edi peak, Edi minimum, peak inspiratory pressure, time in backup ventilation, and number of switches to backup ventilation-did not change significantly. However, the proportion of phasic pattern significantly increased (before: 46% vs. after: 72%; p < 0.05), whereas the central apnea pattern significantly decreased after doxapram administration (before: 31% vs. after: 8.3%; p < 0.05). The proportion of irregular low-voltage patterns tended to decrease, albeit with no significant changes. Our results indicated that the proportion of Edi waveform patterns changed following doxapram administration. Edi waveform pattern analysis could be a sensitive indicator of effect with other intervention for respiratory conditions.
Substances chimiques
Doxapram
94F3830Q73
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1483-1488Informations de copyright
© 2022 Wiley Periodicals LLC.
Références
Rong X, Liang F, Li YJ, et al. Application of neurally adjusted ventilatory assist in premature neonates less than 1,500 grams with established or evolving bronchopulmonary dysplasia. Front Pediatr. 2020;24:110.
Jung YH, Kim HS, Lee J, Shin SH, Kim EK, Choi JH. Neurally adjusted ventilatory assist in preterm infants with established or evolving bronchopulmonary dysplasia on high-intensity mechanical ventilatory support: a single-center experience. Pediatr Crit Care Med. 2016;17:1142-1146.
Rossor TE, Hunt KA, Shetty S, Greenough A. Neurally adjusted ventilatory assist compared to other forms of triggered ventilation for neonatal respiratory support. Cochrane Database. Syst Rev. 2017;27(10):CD012251.
Kallio M, Koskela U, Peltoniemi O, et al. Neurally adjusted ventilatory assist (NAVA) in preterm newborn infants with respiratory distress syndrome-a randomized controlled trial. Eur J Pediatr. 2016;175:1175-1183.
Eichenwald EC, Committee on Fetus and Newborn, American Academy of Pediatrics. Apnea of prematurity. Pediatrics. 2016;137:e20153757.
Stein H, Howard D. Neurally adjusted ventilatory assist in neonates weighing < 1500 grams: a retrospective analysis. J Pediatr. 2012;160:786-789.
Peliowski A, Finer NN. A blinded, randomized, placebo-controlled trial to compare theophylline and doxapram for the treatment of apnea of prematurity. J Pediatr. 1990;116:648-653.
liegenthart RJ, Ten Hove CH, Onland W, van Kaam AH. Doxapram treatment for apnea of prematurity: a systematic review. Neonatology. 2017;111:162-171.
Henderson-Smart D, Steer P. Doxapram treatment for apnea in preterm infants. Cochrane Database Syst Rev. 2004;18:CD000074.
Ten Hove CH, Vliegenthart RJ, Te Pas AB, et al. Long-term neurodevelopmental outcome after doxapram for apnea of prematurity. Neonatology. 2016;110:21-26.
Araki R, Tomotaki S, Akita M, et al. Effect of electrical activity of the diaphragm waveform patterns on SpO2 for extremely preterm infants ventilated with neurally adjusted ventilatory assist. Pediatr Pulmonol. 2021;56:2094-2101.
de Waal CG, Hutten GJ, Kraaijenga JV, de Jongh FH, van Kaam AH. Doxapram treatment and diaphragmatic activity in preterm infants. Neonatology. 2019;115:85-88.