Response to the Letter to the Editor: Arrhythmias in the pediatric intensive care unit: a prospective study of the rates and predictors of arrhythmias in children without underlying cardiac disease

• Published in: Cardiology in the young 2017-01, Vol.27 (1), p.205-206
• Main Authors: Cassel-Choudhury, Gina N., Aydin, Scott I., Ushay, Henry M., Ceresnak, Scott R.
• Format: Article
• Language: English
• Subjects: Asthma; Cardiac arrhythmia; Editors; Letters to the Editor
• ISSN: 1047-9511; 1467-1107
• DOI: 10.1017/S1047951116001475

The National Asthma Education and Prevention Program published their most recent guidelines for management of acute asthma exacerbation, and methylxanthines such as aminophylline were not recommended.6In the emergency department, aminophylline appears to provide no additional benefit to optimal short-acting beta agonists and increases the frequency of adverse effects.7Even as failing to show a reduction in nebulised treatments or length of hospital stay in children, studies have actually shown increased toxicity in those being treated with methylxanthine for severe asthma exacerbation.8Therefore, although the data from Axelrod et al would suggest that there is no additional arrhythmia risk in postoperative cardiac patients, the combination of a possible arrhythmia risk in the asthmatic population, coupled with limited clinical benefit, would leave the authors to question the use of aminophylline in patients with asthma exacerbations.