口服多克萨普拉姆治疗早产性呼吸暂停:一个随机剂量试验
Jane M Canning1,2, Jacqueline A Hannam3, Julena Ardern4
1Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand. jane.canning@auckland.ac.nz.
概括
口服多克萨普拉姆可用于非常早产的婴儿,改善氧化和通风. 较低的剂量 (12 mg/kg/6 h) 通常足以达到治疗性血度.
科学领域:
- 新生儿医学 新生儿医学
- 药理学 药理学是指药理学的学科.
- 呼吸系统生理学 呼吸系统生理学
背景情况:
- 在非常早产的婴儿中,呼吸暂停和不和是很常见的.
- 目前的治疗方法,如咖啡因酸盐,可能并不总是足够的.
- 探索用于呼吸支的替代性或辅助疗法至关重要.
研究的目的:
- 评估口服多克萨普拉姆在非常早产婴儿中使用剂量的可行性.
- 为了确定口服多克萨普拉姆的适当剂量方案.
- 评估口服多克萨普拉姆对呼吸系统参数的影响.
主要方法:
- 一个第二阶段的开放性随机试验比较了两个口服多克萨普拉姆疗法 (较高剂量与较低剂量) 在怀孕32周以下的婴儿中.
- 在维持剂量后2-4小时测量了稳定状态多克萨普拉姆度.
- 在整个研究过程中进行了氧度测量,胃超声波和临床评估.
主要成果:
- 较低剂量方案 (12 mg/kg/6 h) 在47%的婴儿中达到治疗性多克萨普拉姆血度,而在高剂量组中为13%.
- 在高剂量组中的大多数婴儿 (88%) 超过了治疗范围.
- 口服多克萨普拉姆改善了氧和度 (SpO2) 并减少了补充氧气 (FiO2) 和通风支持 (pCO2) 的需要.
结论:
- 口服多克萨普拉姆是一种可行的治疗非常早产的婴儿,需要呼吸辅助.
- 口服多克萨普拉姆的较低维护剂量 (12 mg/kg/6 h) 似乎足以在大多数婴儿中达到治疗水平.
- 口服多克萨普拉姆可以有效地改善这种脆弱人群的氧化和通风.
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