Ketamine versus aminophylline for acute asthma in children: A randomized, controlled trial.
BACKGROUND
There is a lack of consensus regarding second-line therapy in children with acute asthma who fail to the standard therapy. Ketamine had bronchodilator property and may be useful in the treatment of acute asthma.


OBJECTIVE
The objective of this study was to evaluate the efficacy and safety of ketamine as compared to aminophylline in children with acute asthma who respond poorly to the standard therapy.


METHODS
This randomized controlled trial included patients with acute asthma having Pediatric Respiratory Assessment Measure (PRAM) score ≥5 at 2 h of standard therapy. The enrolled patients received either intravenous (IV) ketamine or IV aminophylline. Primary outcome measure was change in PRAM score at the end of intervention. Secondary outcome measures included adverse effects, change in PO2and PCO2, need for mechanical ventilation, and duration of hospital stay.


RESULTS
The trial included 24 patients each in ketamine and aminophylline groups. The baseline parameters were similar between the groups. The primary outcome was similar in both the groups with a change in PRAM score of 4.00 ± 1.25 and 4.17 ± 1.68 (P= 0.699) in ketamine and aminophylline groups, respectively. The secondary outcomes were not different between the groups.


CONCLUSIONS
Ketamine and aminophylline were equally effective for children with acute asthma who responded poorly to the standard therapy.
Department of Pediatrics, Government Medical College Hospital, Chandigarh, India.
Abhimanyu
A
Tiwari
Department of Pediatrics, Government Medical College Hospital, Chandigarh, India.
Vishal
V
Guglani
Department of Pediatrics, Government Medical College Hospital, Chandigarh, India; Department of Pediatrics, All Institute of Medical Sciences, New Delhi, India.
Kana Ram
KR
Jat
Acute asthma; aminophylline; children; ketamine