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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, Joachim W.

Editorial Board Member: / Bancalari, Eduardo / Greenough, Anne / Genc, Mehmet R. / Chervenak, Frank A. / Chappelle, Joseph / Bergmann, Renate L. / Bernardes, J.F. / Bevilacqua, G. / Blickstein, Isaac / Cabero Roura, Luis / Carbonell-Estrany, Xavier / Carrera, Jose M. / D`Addario, Vincenzo / D'Alton, MD, Mary E. / Dimitrou, G. / Grunebaum, Amos / Hentschel, Roland / Köpcke, W. / Kawabata, Ichiro / Keirse, Marc J.N.C. / Kurjak M.D., Asim / Lee, Ben H. / Levene, Malcolm / Lockwood, Charles J. / Marsal, Karel / Makatsariya, Alexander / Nishida, Hiroshi / Ogata, Edward / Papp, Zoltán / Pejaver, Ranjan Kumar / Pooh, Ritsuko K. / Romero, Roberto / Saugstad, Ola D. / Schenker, Joseph G. / Sen, Cihat / Seri, Istvan / Vetter, Klaus / Winn, Hung N. / Young, Bruce K. / Zimmermann, Roland


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Dynamic QT/RR relationship of cardiac conduction in premature infants treated with low-dose doxapram hydrochloride

Masafumi Miyata1 / Tadayoshi Hata2 / Noriko Kato3 / Masatomo Takeuchi4 / Hiroko Mizutani5 / Masamichi Kubota6 / Toshio Yamazaki7

1Department of Pediatrics, School of Medicine, Fujita Health University Toyoake, Aichi, Japan

2Department of Clinical Pathophysiology, Graduate School of Health Science, Fujita Health University, Japan

3Department of Pediatrics, School of Medicine, Fujita Health University Toyoake, Aichi, Japan

4Department of Pediatrics, School of Medicine, Fujita Health University Toyoake, Aichi, Japan

5Department of Pediatrics, School of Medicine, Fujita Health University Toyoake, Aichi, Japan

6Department of Pediatrics, School of Medicine, Fujita Health University Toyoake, Aichi, Japan

7Department of Pediatrics, School of Medicine, Fujita Health University Toyoake, Aichi, Japan

Corresponding author: Masafumi Miyata, MD, PhD Department of Pediatrics School of Medicine Fujita Health University 1-98 Dengakugakubo Kutsukake-cho Toyoake, Aichi Japan 470-1192 Tel.: +81-562-93-9251 Fax: +81-562-95-2216

Citation Information: Journal of Perinatal Medicine. Volume 35, Issue 4, Pages 330–333, ISSN (Online) 03005577, ISSN (Print) 16193997, DOI: 10.1515/JPM.2007.068, July 2007

Publication History

Received:
2006-12-07
Revised:
2007-04-11
Accepted:
2007-05-14
Published Online:
2007-07-05

Abstract

Doxapram hydrochloride, a respiratory stimulant, has several undesirable side effects during high-dose administration, including second-degree atrioventricular (AV) block and QT prolongation. In Japan, this drug is contraindicated for newborn infants. Recent studies, however, have demonstrated the efficacy and safety of doxapram therapy for apnea of prematurity (AOP) using lower doses than those previously tested. As a result, approximately 60% of Japanese neonatologists continue to use this drug. This study used surface ECG recordings to assess the cardiac safety of low-dose doxapram hydrochloride (0.2 mg/kg/h) in fifteen premature very-low-birth-weight infants with idiopathic AOP. Cardiac intervals and number of apnea episodes were compared before and after drug administration. Low-dose doxapram hydrochloride resulted in approximately 90% reduction in the frequency of apnea without side effects. None of the infants developed QT or PR prolongation, arrhythmia, or other conduction disorders. In addition, there was no change in the slope of QT/RR before versus after administration of doxapram hydrochloride. We conclude that low-dose administration of doxapram hydrochloride did not have any undesirable effects on myocardial depolarization and repolarization.

Keywords: Apnea of prematurity; atrioventricular conduction; doxapram hydrochloride; QT interval; QT/RR relationship

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