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Morphine increases synchronous ventilation in preterm infants

M P Dyke1, R Kohan, S Evans

  • 1Department of Newborn Services, King Edward Memorial Hospital, Subiaco, Australia.

Journal of Paediatrics and Child Health
|June 1, 1995
PubMed
Summary
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Intravenous morphine infusion improved breathing synchrony in preterm infants. This treatment reduced heart rate, respiratory rate, and oxygen therapy duration, aiding recovery for infants with hyaline membrane disease.

Area of Science:

  • Neonatal Medicine
  • Pediatric Critical Care
  • Pharmacology

Background:

  • Preterm infants with hyaline membrane disease often require mechanical ventilation.
  • Optimizing cardiorespiratory stability and synchrony with ventilators is crucial for improving outcomes in this vulnerable population.

Purpose of the Study:

  • To evaluate the short-term cardiorespiratory effects of intravenous morphine infusion in ventilated preterm infants.
  • To assess morphine's impact on respiratory synchrony and clinical outcomes.

Main Methods:

  • A randomized, double-blind, placebo-controlled trial was conducted in a neonatal intensive care unit.
  • Twenty-six preterm infants (29-36 weeks gestation) received morphine (100 mcg/kg loading dose followed by 10 mcg/kg/hr infusion) or placebo.
  • Primary endpoints included heart rate, blood pressure, respiratory rate, and spontaneous breathing synchrony with mechanical ventilation.

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Main Results:

  • Morphine significantly increased the percentage of time infants spent breathing in synchrony with ventilators (72% vs 31%, P = 0.0008).
  • Heart rate and respiratory rate were reduced in the morphine group, but blood pressure remained unaffected.
  • The duration of oxygen therapy was significantly shorter in infants receiving morphine (4.5 days vs 8 days, P = 0.046).

Conclusions:

  • Intravenous morphine infusion enhances spontaneous and ventilator breath synchrony in preterm infants.
  • Morphine effectively reduces heart rate and respiratory rate without compromising blood pressure.
  • The findings suggest that morphine may reduce the duration of oxygen therapy in preterm infants with hyaline membrane disease.