To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: Aminophylline an Effective Diuretic for Critically Ill Children With Respiratory Diseases: Presented at AAP URL: http://www.pslgroup.com/dg/22EFCA.htm Doctor's Guide October 17, 2008
By Martha Kerr, BSN BOSTON -- October 17, 2008 -- The bronchodilator aminophylline is an effective and apparently safe diuretic for paediatric patients in critical care, researchers reported here of the American Academy of Pediatrics (AAP) 2008 National Conference & Exhibition. Aminophylline increased urine output with no apparent adverse effects on the lung or kidney, said Robert F. Tamburro, MD, Department of Pediatrics and Department of Critical Care Medicine, Penn State Children's Hospital, Hersey, Pennsylvania, in a presentation on October 12. Dr. Tamburro and colleagues conducted a prospective, uncontrolled observational trial to assess the impact of aminophylline on pulmonary and renal function over a 24-hour period in 33 critically ill children, 28 of whom were mechanically ventilated. Researchers collected data on demographics, diagnoses, medications, vital signs, urine output, blood urea nitrogen (BUN), and creatinine. The 4 most common diagnoses in the cohort were bronchiolitis, pneumonia, congenital heart disease, and sepsis. Data collection was repeated 24 hours after initiation of aminophylline treatment. Pulmonary function testing was conducted on the 28 intubated patients. The method of administration and dosing of aminophylline were determined by the patient's clinical team. Target drug levels were 10 to 20 mcg/mL with continuous infusion, and trough levels were 4 to 8 mcg/mL for intermittent dosing. Three patients received continuous infusions. Thirty-one patients were receiving other diuretics at initiation of aminophylline therapy. Six had their diuretic dose increased during the study, while 25 patients had no increase in their diuretic dose during the study. Urine output increased from a mean of 3.8 cc/kg/hour (range, 3.3-4.3) at baseline to 5.1 cc/kg/hour (range, 4.4-5.8) at 24 hours (P = .005). Similar increases in urinary output were observed in the 25 patients whose diuretic doses were not changed during the study period. BUN did not change during the 24-hour period. Mean BUN was 19.1 mg/dL (range, 16.4-21.8 mg/dL) at baseline and 20.3 mg/dL at 24 hours (range, 16.9-23.7 mg/dL). Creatinine was similarly unchanged with aminophylline therapy, with a mean of 0.62 mg/dL (± 0.13) at baseline and 0.67 mg/dL (± 0.17) at 24 hours. Airway resistance at 24 hours decreased from baseline, with a trend toward significance (-10.6 ± 5.7, P = .08). There was no change in static or dynamic compliance. Adverse events were observed in 6 patients and included agitation, increased nasogastric output, ventricular ectopy, and tachydysrhythmias. "Although other explanations existed for these side effects, [aminophylline] was discontinued in 4 instances," Dr. Tamburro said. "Aminophylline appears to be a useful secondary diuretic for critically ill children," the researchers concluded. [Presentation title: Impact of Aminophylline on Renal and Pulmonary Function in Critically Ill Children. Abstract 563] --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.