Evaluation of premixed intravenous theophylline loading doses

Area of Science:

• Pharmacology and Therapeutics
• Critical Care Medicine

Background:

• Intravenous aminophylline is traditionally used for loading doses in critically ill patients.
• Accurate calculation and administration of aminophylline loading doses can be complex in critical care settings.

Purpose of the Study:

• To compare the efficacy of a simplified theophylline loading dose protocol using premixed containers against traditional intravenous aminophylline loading doses.
• To evaluate the impact of rounding theophylline doses on achieving predicted peak serum concentrations.

Main Methods:

• A prospective study involving 19 critically ill adults.
• Comparison of premixed theophylline infusions using a simplified, rounded dosing protocol (nearest 100 mg) versus precisely calculated intravenous aminophylline loading doses.
• Blood samples were collected pre- and post-infusion to measure theophylline concentrations.
• Statistical analysis included matched pair t-tests and computation of mean squared prediction errors and root mean squared errors.

Main Results:

• The simplified theophylline dosing protocol resulted in peak theophylline concentrations that were not statistically significantly different from those achieved with traditional aminophylline loading doses.
• Both methods demonstrated comparable performance in achieving predicted peak concentrations, as indicated by error metrics.

Conclusions:

• A standard protocol utilizing premixed theophylline containers with doses rounded to the nearest 100 mg is a clinically acceptable alternative for aminophylline loading doses in critically ill adults.
• This simplified approach simplifies administration without compromising the achievement of therapeutic peak theophylline concentrations.