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Efficacy of IV Aminophylline as a Supplemental Therapy in Moderate Broncho-obstructive Crisis in Infants and Preschool Children

2000; Elsevier BV; Volume: 13; Issue: 4 Linguagem: Inglês

10.1006/pupt.1999.0225

1522-9629

Sandra Elisabete Vieira, João Paulo Becker Lotufo, Bernardo Ejzenberg, Yassuhiko Okay,

Asthma and respiratory diseases

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.