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Retrospective Comparison of Caffeine and Doxapram for the Treatment of Hypercapnia in Foals with Hypoxic‐Ischemic Encephalopathy

2008; Wiley; Volume: 22; Issue: 2 Linguagem: Inglês

10.1111/j.1939-1676.2008.0064.x

1939-1676

Steeve Giguére, J.K. Slade, L. Chris Sanchez,

Neonatal and fetal brain pathology

Background: Despite a lack of data regarding their efficacy, both caffeine and doxapram have been recommended for treatment of hypercapnia in equine neonates with central nervous system damage. Hypothesis: Caffeine and doxapram alleviate hypercapnia in foals with hypoxic‐ischemic encephalopathy. Animals: Sixteen foals treated with either caffeine (n = 8) or doxapram (n = 8). Methods: Information on age, body temperature, heart rate, respiratory rate, arterial blood gas parameters, duration of therapy, and outcome was abstracted from each medical record. Results: Therapy with doxapram resulted in a significant decrease in partial pressure of carbon dioxide (PaCO 2 [ P = .004]), bicarbonate concentration ( P = .002), and base excess ( P = .005) compared with baseline values but failed to correct acidemia. In contrast, administration of caffeine did not result in significant changes from baseline values. The percentage decrease in PaCO 2 and bicarbonate concentration was significantly greater in foals treated with doxapram than in foals treated with caffeine ( P = .004). The proportions of foals that achieved the targeted PaCO 2 (≤ 50 mmHg) were significantly higher in foals treated with doxapram than in foals treated with caffeine ( P = .029). The proportion of survivors in the 2 treatment groups was not significantly different. Conclusions and Clinical Importance: Doxapram is more effective than caffeine for rapid correction of hypercapnia in foals with hypoxic‐ischemic encephalopathy.