[A pharmacologic respiratory stimulant, doxapram, used in acute deterioration in patients with chronic respiratory failure]

In a controlled study with random allocation, the effect of doxapram (Dopram), a respiratory stimulant, was evaluated in 25 patients with acute on chronic respiratory failure requiring ventilator support. Eleven patients were allocated to mechanical ventilation and 14 to treatment with doxapram given as a variable rate infusion. In the doxapram group only four were transferred to mechanical ventilation after 1 1/2 to three days of treatment. In these patients, the problem giving rise to the acute exacerbation, was not under control at the time of ventilator intervention. In the remainder of the group, antibiotics, diuretics and bronchodilators had successfully treated the exacerbation. All patients were discharged alive. In the doxapram-treated group duration of hospitalization was nine days compared to 14 days (median values) in the ventilator-treated group. Only minor side-effects from doxapram were observed, and it is concluded that this respiratory stimulant can be used as a primary drug in patients with acute respiratory failure and chronic airflow limitation.