01 August 2007
Aminophylline treatment of refractory bronchospasm in mechanically ventilated neonates: Case report
Claudio Migliori, Elena Garzoli, Vania Spinoni, Gaetano ChiricoMed Sci Monit 2007; 13(8): CS93-96 :: ID: 491659
Abstract
Background: The aim was to determine the effectiveness of continuous aminophylline infusion on refractory bronchospasm in long-term mechanically ventilated neonates.
Case Report: Presented are seven newborns with gestational ages from 24 to 38 weeks and mean age at treatment of 29.7 days. All were mechanically ventilated from birth because of respiratory distress syndrome. Bronchospasm was diagnosed by wheezing, worsening of gas exchange, lengthening of expiratory time, and the need to modify the peak inspiratory pressure (PIP) to maintain the tidal volume. All patients had received conventional bronchodilator treatment for more than 24 hours before aminophylline treatment, without significant response. After discontinuation of previous bronchodilator drugs, an intravenous 6 mg/kg aminophylline bolus was administered over 20 minutes, followed by continuous infusions of 0.7 mg/kg/h for 12 hours and 0.35 mg/kg/h during the next 12 hours. Altogether, the treatment was carried out for 24 hours. Pulse-oximetry saturation (SpO[sub]2[/sub]), transcutaneous pO[sub]2[/sub]/pCO[sub]2[/sub] (TcPO[sub]2[/sub]/PCO[sub]2[/sub]), heart rate, blood pressure, mean airway pressure (MAP), and fraction of inspired oxygen (FiO[sub]2[/sub]) were recorded before and after the treatment. The SpO[sub]2[/sub] (p<0.005) and TcPO2 (p<0.002) increased significantly, while significant reductions in TcPCO2 (p<0.00008) and FiO2 (p<0.03) were observed. No signs of toxicity or significant differences in heart rate or blood pressure were reported. Mean serum aminophylline concentration resulted in therapeutic levels at both 12 and 24 hours.
Conclusions: It is suggested that continuous infusion of aminophylline is well tolerated and may prove useful in improving the gas exchange in long-term mechanically ventilated neonates with refractory bronchospasm.
Keywords: Aminophylline - therapeutic use, Respiratory Insufficiency - drug therapy, Respiration, Artificial - methods, Oxygen - metabolism, Oximetry, Infant, Premature, Infant, Newborn, Heart Rate, Gestational Age, Bronchodilator Agents - therapeutic use, Bronchial Spasm - drug therapy, Blood Pressure, Blood Pressure, Respiratory Insufficiency - drug therapy, Respiration, Artificial - methods, Oxygen - metabolism, Oximetry, Infant, Premature, Infant, Newborn, Heart Rate, Gestational Age, Bronchodilator Agents - therapeutic use, Bronchial Spasm - drug therapy, Aminophylline - therapeutic use
Editorial
01 March 2024 : Editorial
Editorial: First Regulatory Approvals for CRISPR-Cas9 Therapeutic Gene Editing for Sickle Cell Disease and Transfusion-Dependent β-ThalassemiaDOI: 10.12659/MSM.944204
Med Sci Monit 2024; 30:e944204
In Press
21 Feb 2024 : Clinical Research
Potential Value of HSP90α in Prognosis of Triple-Negative Breast CancerMed Sci Monit In Press; DOI: 10.12659/MSM.943049
22 Feb 2024 : Review article
Differentiation of Native Vertebral Osteomyelitis: A Comprehensive Review of Imaging Techniques and Future ...Med Sci Monit In Press; DOI: 10.12659/MSM.943168
23 Feb 2024 : Clinical Research
A Study of 60 Patients with Low Back Pain to Compare Outcomes Following Magnetotherapy, Ultrasound, Laser, ...Med Sci Monit In Press; DOI: 10.12659/MSM.943732
26 Feb 2024 : Clinical Research
Predictive Value of Combined HbA1c and Neutrophil-to-Lymphocyte Ratio for Diabetic Peripheral Neuropathy in...Med Sci Monit In Press; DOI: 10.12659/MSM.942509
Most Viewed Current Articles
17 Jan 2024 : Review article
Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron VariantDOI :10.12659/MSM.942799
Med Sci Monit 2024; 30:e942799
16 May 2023 : Clinical Research
Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...DOI :10.12659/MSM.940387
Med Sci Monit 2023; 29:e940387
14 Dec 2022 : Clinical Research
Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase LevelsDOI :10.12659/MSM.937990
Med Sci Monit 2022; 28:e937990
01 Jan 2022 : Editorial
Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...DOI :10.12659/MSM.935952
Med Sci Monit 2022; 28:e935952