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. 1998 Nov;79(5):405–410. doi: 10.1136/adc.79.5.405

Randomised controlled trial of aminophylline for severe acute asthma

M Yung 1, M South 1
PMCID: PMC1717748  PMID: 10193252

Abstract

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 enrolment 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.



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Selected References

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  1. Bishop J., Carlin J., Nolan T. Evaluation of the properties and reliability of a clinical severity scale for acute asthma in children. J Clin Epidemiol. 1992 Jan;45(1):71–76. doi: 10.1016/0895-4356(92)90190-x. [DOI] [PubMed] [Google Scholar]
  2. Carter E., Cruz M., Chesrown S., Shieh G., Reilly K., Hendeles L. Efficacy of intravenously administered theophylline in children hospitalized with severe asthma. J Pediatr. 1993 Mar;122(3):470–476. doi: 10.1016/s0022-3476(05)83443-2. [DOI] [PubMed] [Google Scholar]
  3. Coleridge J., Cameron P., Epstein J., Teichtahl H. Intravenous aminophylline confers no benefit in acute asthma treated with intravenous steroids and inhaled bronchodilators. Aust N Z J Med. 1993 Aug;23(4):348–354. doi: 10.1111/j.1445-5994.1993.tb01434.x. [DOI] [PubMed] [Google Scholar]
  4. Cox R. G., Barker G. A., Bohn D. J. Efficacy, results, and complications of mechanical ventilation in children with status asthmaticus. Pediatr Pulmonol. 1991;11(2):120–126. doi: 10.1002/ppul.1950110208. [DOI] [PubMed] [Google Scholar]
  5. DiGiulio G. A., Kercsmar C. M., Krug S. E., Alpert S. E., Marx C. M. Hospital treatment of asthma: lack of benefit from theophylline given in addition to nebulized albuterol and intravenously administered corticosteroid. J Pediatr. 1993 Mar;122(3):464–469. doi: 10.1016/s0022-3476(05)83442-0. [DOI] [PubMed] [Google Scholar]
  6. Fanta C. H., Rossing T. H., McFadden E. R., Jr Emergency room of treatment of asthma. Relationships among therapeutic combinations, severity of obstruction and time course of response. Am J Med. 1982 Mar;72(3):416–422. doi: 10.1016/0002-9343(82)90498-3. [DOI] [PubMed] [Google Scholar]
  7. Huang D., O'Brien R. G., Harman E., Aull L., Reents S., Visser J., Shieh G., Hendeles L. Does aminophylline benefit adults admitted to the hospital for an acute exacerbation of asthma? Ann Intern Med. 1993 Dec 15;119(12):1155–1160. doi: 10.7326/0003-4819-119-12-199312150-00001. [DOI] [PubMed] [Google Scholar]
  8. Josephson G. W., MacKenzie E. J., Lietman P. S., Gibson G. Emergency treatment of asthma. A comparison of two treatment regimens. JAMA. 1979 Aug 17;242(7):639–643. [PubMed] [Google Scholar]
  9. Knudson R. J., Lebowitz M. D., Holberg C. J., Burrows B. Changes in the normal maximal expiratory flow-volume curve with growth and aging. Am Rev Respir Dis. 1983 Jun;127(6):725–734. doi: 10.1164/arrd.1983.127.6.725. [DOI] [PubMed] [Google Scholar]
  10. Murphy D. G., McDermott M. F., Rydman R. J., Sloan E. P., Zalenski R. J. Aminophylline in the treatment of acute asthma when beta 2-adrenergics and steroids are provided. Arch Intern Med. 1993 Aug 9;153(15):1784–1788. [PubMed] [Google Scholar]
  11. Needleman J. P., Kaifer M. C., Nold J. T., Shuster P. E., Redding M. M., Gladstein J. Theophylline does not shorten hospital stay for children admitted for asthma. Arch Pediatr Adolesc Med. 1995 Feb;149(2):206–209. doi: 10.1001/archpedi.1995.02170140088016. [DOI] [PubMed] [Google Scholar]
  12. Pierson W. E., Bierman C. W., Stamm S. J., Van Arsdel P. P., Jr Double-blind trial of aminophylline in status asthmaticus. Pediatrics. 1971 Oct;48(4):642–646. [PubMed] [Google Scholar]
  13. Rodrigo C., Rodrigo G. Treatment of acute asthma. Lack of therapeutic benefit and increase of the toxicity from aminophylline given in addition to high doses of salbutamol delivered by metered-dose inhaler with a spacer. Chest. 1994 Oct;106(4):1071–1076. doi: 10.1378/chest.106.4.1071. [DOI] [PubMed] [Google Scholar]
  14. Rossing T. H., Fanta C. H., McFadden E. R., Jr A controlled trial of the use of single versus combined-drug therapy in the treatment of acute episodes of asthma. Am Rev Respir Dis. 1981 Feb;123(2):190–194. doi: 10.1164/arrd.1981.123.2.190. [DOI] [PubMed] [Google Scholar]
  15. Schuh S., Johnson D. W., Callahan S., Canny G., Levison H. Efficacy of frequent nebulized ipratropium bromide added to frequent high-dose albuterol therapy in severe childhood asthma. J Pediatr. 1995 Apr;126(4):639–645. doi: 10.1016/s0022-3476(95)70368-3. [DOI] [PubMed] [Google Scholar]
  16. Self T. H., Abou-Shala N., Burns R., Stewart C. F., Ellis R. F., Tsiu S. J., Kellermann A. L. Inhaled albuterol and oral prednisone therapy in hospitalized adult asthmatics. Does aminophylline add any benefit? Chest. 1990 Dec;98(6):1317–1321. doi: 10.1378/chest.98.6.1317. [DOI] [PubMed] [Google Scholar]
  17. Siegel D., Sheppard D., Gelb A., Weinberg P. F. Aminophylline increases the toxicity but not the efficacy of an inhaled beta-adrenergic agonist in the treatment of acute exacerbations of asthma. Am Rev Respir Dis. 1985 Aug;132(2):283–286. doi: 10.1164/arrd.1985.132.2.283. [DOI] [PubMed] [Google Scholar]
  18. Storr J., Barrell E., Barry W., Lenney W., Hatcher G. Effect of a single oral dose of prednisolone in acute childhood asthma. Lancet. 1987 Apr 18;1(8538):879–882. doi: 10.1016/s0140-6736(87)92857-1. [DOI] [PubMed] [Google Scholar]
  19. Strauss R. E., Wertheim D. L., Bonagura V. R., Valacer D. J. Aminophylline therapy does not improve outcome and increases adverse effects in children hospitalized with acute asthmatic exacerbations. Pediatrics. 1994 Feb;93(2):205–210. [PubMed] [Google Scholar]
  20. Wrenn K., Slovis C. M., Murphy F., Greenberg R. S. Aminophylline therapy for acute bronchospastic disease in the emergency room. Ann Intern Med. 1991 Aug 15;115(4):241–247. doi: 10.7326/0003-4819-115-4-241. [DOI] [PubMed] [Google Scholar]
  21. Zainudin B. M., Ismail O., Yusoff K. Effect of adding aminophylline infusion to nebulised salbutamol in severe acute asthma. Thorax. 1994 Mar;49(3):267–269. doi: 10.1136/thx.49.3.267. [DOI] [PMC free article] [PubMed] [Google Scholar]

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