title: A prospective assessment of the effect of aminophylline therapy on urine output and inflammation in critically ill children.
abstract: BACKGROUND
  Aminophylline, an established bronchodilator, is also purported to be an effective diuretic and anti-inflammatory agent. However, the data to support these contentions are scant. We conducted a prospective, open-label, single arm, single center study to assess the hypothesis that aminophylline increases urine output and decreases inflammation in critically ill children.
  
  
  METHODS
  Children less than 18 years of age admitted to the pediatric intensive care unit who were prescribed aminophylline over a 24-h period were eligible for study. The use and dosing of aminophylline was independent of the study and was at the discretion of the clinical team. Data analyzed consisted of demographics, diagnoses, medications, and markers of pulmonary function, renal function, and inflammation. Data were collected at baseline and at 24-h after aminophylline initiation with primary outcomes of change in urine output and inflammatory cytokine concentrations.
  
  
  RESULTS
  Thirty-five patients were studied. Urine output increased significantly with aminophylline use [median increase 0.5 mL/kg/h (IQR: -0.3, 1.3), p = 0.05] while blood urea nitrogen and creatinine concentrations remained unchanged. Among patients with elevated C-reactive protein concentrations, levels of both interleukin-6 (IL-6) and IL-10 decreased at 24 h of aminophylline therapy. There were no significant differences in pulmonary compliance or resistance among patients invasively ventilated at both time points. Side effects of aminophylline were detected in 7 of 35 patients.
  
  
  CONCLUSIONS
  Although no definitive conclusions can be drawn from this study, aminophylline may be a useful diuretic and effective anti-inflammatory medication in critically ill children. Given the incidence of side effects, the small sample size and the uncontrolled study design, further study is needed to inform the appropriate use of aminophylline in these children.
authors: Department of Pediatrics, Division of Critical Care Medicine, Penn State Hershey Children's Hospital, Pennsylvania State University College of Medicine , Hershey, PA , USA.
authors: Robert F
authors: RF
authors: Tamburro
authors: Department of Pediatrics, Division of Critical Care Medicine, Penn State Hershey Children's Hospital, Pennsylvania State University College of Medicine , Hershey, PA , USA.
authors: Neal J
authors: NJ
authors: Thomas
authors: Department of Pediatrics, Division of Critical Care Medicine, Penn State Hershey Children's Hospital, Pennsylvania State University College of Medicine , Hershey, PA , USA.
authors: Gary D
authors: GD
authors: Ceneviva
authors: Department of Pediatrics, Division of Critical Care Medicine, Penn State Hershey Children's Hospital, Pennsylvania State University College of Medicine , Hershey, PA , USA.
authors: Michael D
authors: MD
authors: Dettorre
authors: Pharmacy Administration and Education Department, Milton S. Hershey Medical Center, Pennsylvania State University College of Medicine , Hershey, PA , USA.
authors: Gretchen L
authors: GL
authors: Brummel
authors: Department of Pediatrics, Division of Critical Care Medicine, Penn State Hershey Children's Hospital, Pennsylvania State University College of Medicine , Hershey, PA , USA.
authors: Steven E
authors: SE
authors: Lucking
keywords: acute kidney injury; adenosine receptor blockade; aminophylline; inflammation; pediatrics; phosphodiesterase inhibition; respiratory function