Efficacy of IV aminophylline as a supplemental therapy in moderate broncho-obstructive crisis in infants and preschool children.

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.