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Blood potassium and urine aldosterone after doxapram therapy for preterm infants

Journal of Perinatology volume 38, pages 702–707 (2018)Cite this article

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Abstract

Objective:

We often encounter infants who developed hypokalaemia following low-dose doxapram for apnea of prematurity (AOP).

Aims:

To determine changes in blood potassium (K+) levels after doxapram administration.

Study design:

We studied infants born before 30 weeks gestation. Doxapram (0.1–0.3 mg/kg/h) in addition to methylxanthines was used to treat AOP refractory to methylxanthines.

Results:

Twenty-five infants received doxapram were studied. Fifty-two percent developed hypokalemia (<3.0 mEq/L) during doxapram administration. Time after starting doxapram to nadir blood K+ (<3.0 mEq/L) level was 11 days. Blood K+ levels normalized after 5 days of stopping doxapram administration. Data at 10 days before and after and at the time of doxapram administration were, respectively: lowest blood K+ level: 3.9, 3.0, and 3.6 mEq/L; urine aldosterone: 90, 206, and 146 pg/μg creatinine. Blood pH, blood pressure and urine volume were similar.

Conclusions:

Doxapram-induced hypokalemia may be due to an inappropriate increase in aldosterone levels.

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Authors and Affiliations

  1. Department of Neonatology, Kanagawa Children’s Medical Center, Yokohama, 232-8555, Japan

    Tomoyuki Shimokaze, Katsuaki Toyoshima, Jun Shibasaki & Yasufumi Itani

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  1. Tomoyuki Shimokaze
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  2. Katsuaki Toyoshima
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  3. Jun Shibasaki
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  4. Yasufumi Itani
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Correspondence to Tomoyuki Shimokaze.

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The authors declare that they have no conflict of interest.

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Ethical approval was obtained by Institutional Review Board of Kanagawa Children’s Medical Center.

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Shimokaze, T., Toyoshima, K., Shibasaki, J. et al. Blood potassium and urine aldosterone after doxapram therapy for preterm infants. J Perinatol 38, 702–707 (2018). https://doi.org/10.1038/s41372-018-0087-x

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