Efficacy of IV aminophylline as a supplemental therapy in moderate broncho-obstructive crisis in infants and preschool children.
The aim of the present study was to investigate the efficacy of iv aminophylline as a supplemental therapy for wheezy infants and preschool children who still present moderate broncho-obstruction after treatment with nebulized fenoterol. A prospective randomized, double blind, placebo-controlled trial was conducted in a Paediatric Emergency Room. The major selection criteria for patients>> inclusion were age between 1 and 7 years, a wheezy episode lasting less than 2 days which failed to respond to three sequential fenoterol nebulizations, a Wood-Downes score between 3 and 6, and a history of at least two similar episodes. Exclusion criteria were radiologically-identified pulmonary condensation, recent use of corticosteroid and/or theophylline drugs, and previous diagnosis of chronic conditions. A sample of 43 cases was selected: 24 in Group A and 19 in Control Group B. All patients were submitted to nebulization with fenoterol and intravenous hydrocortisone for a maximum period of 24 h. Only Group A patients received iv aminophylline (6 mg/kg in bolus and 1.2 mg/kg per h for maintenance schedule). Treatment efficacy parameters established for the two groups were based on the Wood-Downes clinical score. Throughout the study, the average clinical scores and the discharge rate were similar for both groups. The average stay in the Emergency Room was 12.5 h for Group A and 14.6 h for Control Group B. In conclusion, the use of supplemental iv aminophylline for moderate broncho-obstructive crisis in wheezy infants and preschool children did not add therapeutically significant results to the usually prescribed combination of nebulized beta-adrenergic and intravenous corticosteroid drugs.
Vieira
S E
SE
University Hospital, Paediatrics Division, São Paulo, Brazil.
Lotufo
J P
JP
Ejzenberg
B
B
Okay
Y
Y
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D000628:Aminophylline / Q000008:administration & dosage / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D016084:Bronchoconstriction / Q000187:drug effects; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous; D008297:Male; D011446:Prospective Studies
D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D001993:Bronchodilator Agents; D000628:Aminophylline