Related Experiment Videos
Randomised controlled trial of aminophylline for severe acute asthma
Insights
Adding intravenous aminophylline to standard treatment significantly improved outcomes for children with severe acute asthma unresponsive to initial therapy. This approach reduced the need for mechanical ventilation.
Area of Science:
- Pediatric Emergency Medicine
- Respiratory Medicine
- Clinical Pharmacology
Background:
- Severe acute asthma in children requires aggressive initial treatment.
- Some children remain unresponsive to standard inhaled bronchodilators and systemic steroids.
- The role of adjunctive therapies like aminophylline needs further clarification.
Purpose of the Study:
- To evaluate the efficacy of intravenous aminophylline as an add-on therapy.
- To assess benefits in children with severe acute asthma refractory to initial treatment.
- To determine if aminophylline improves respiratory function and reduces the need for mechanical ventilation.
Main Methods:
- A randomized, double-blind, placebo-controlled trial was conducted.
- 163 children hospitalized with asthma unresponsive to nebulized salbutamol were enrolled.
- Participants received standard care plus either intravenous aminophylline or a placebo.
Main Results:
- The aminophylline group showed greater spirometric improvement at 6 hours.
- Higher oxygen saturation was observed in the aminophylline group for the first 30 hours.
- None of the children in the aminophylline group required intubation, compared to five in the placebo group.
Conclusions:
- Intravenous aminophylline is beneficial for children with severe acute asthma unresponsive to initial management.
- Aminophylline improves respiratory parameters and reduces the need for mechanical ventilation.
- Aminophylline remains a valuable therapeutic option in refractory pediatric asthma cases.
Objectives:
To determine whether children with severe acute asthma treated with large doses of inhaled salbutamol, inhaled ipratropium, and intravenous steroids are conferred any further benefits by the addition of aminophylline given intravenously.
Study Design:
Randomised, double blind, placebo controlled trial of 163 children admitted to hospital with asthma who were unresponsive to nebulised salbutamol.
Results:
The placebo and treatment groups of children were similar at baseline. The 48 children in the aminophylline group had a greater improvement in spirometry at six hours and a higher oxygen saturation in the first 30 hours. Five subjects in the placebo group were intubated and ventilated after enrollment compared with none in the aminophylline group.
Conclusions:
Aminophylline continues to have a place in the management of severe acute asthma in children unresponsive to initial treatment.