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QT interval lengthening in premature infants treated with doxapram

C Maillard1, M J Boutroy, J Fresson

  • 1Neonatal Intensive Care and Perinatal Pharmacology, Maternité Régionale Universitaire, Nancy, France.

Clinical Pharmacology and Therapeutics
|December 26, 2001
PubMed

Insights

Doxapram use in premature infants may prolong the corrected QT (QTc) interval, potentially leading to dangerous heart rhythm disorders. Close electrocardiogram monitoring is essential during doxapram treatment for apnea of prematurity.

Area of Science:

  • Neonatal pharmacology
  • Pediatric cardiology
  • Clinical toxicology

Background:

  • Doxapram is commonly used for apnea of prematurity unresponsive to methylxanthines.
  • Concerns exist regarding doxapram's potential to cause cardiac conduction disorders.

Purpose of the Study:

  • To evaluate the cardiac and general tolerance of doxapram in very premature infants.
  • To assess the relationship between doxapram plasma concentrations and adverse effects.

Main Methods:

  • Prospective evaluation of 40 premature infants receiving intravenous doxapram.
  • Electrocardiogram monitoring (including corrected QT interval - QTc) before and during treatment.
  • Measurement of drug plasma concentrations and recording of side effects.

Main Results:

  • A statistically significant, moderate lengthening of the QTc interval was observed during doxapram treatment.
  • Six infants experienced QTc prolongation exceeding the 440 ms threshold without other rhythm disorders.
  • No correlation was found between adverse effects and drug plasma concentrations.

Conclusions:

  • Doxapram can prolong the QTc interval in premature infants, increasing the risk of exceeding the life-threatening 440 ms threshold.
  • Electrocardiogram monitoring is crucial when administering doxapram to neonates.
Abstract

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