Use of intravenous aminophylline in addition to the standard first-line treatment in children and adolescents with an acute asthma exacerbation: a systematic review and meta-analysis of randomised controlled trials
Bibliographic record
Abstract
Importance The role of intravenous aminophylline in acute asthma in childhood is unclear. Objectives To assess the safety and efficacy of intravenous aminophylline for asthma in children. Methods From 1966 to May 2024, we searched MEDLINE, Embase, CINAHL, Web of Science and the Cochrane Central Register of Controlled Trials. We included only randomised controlled trials testing standard treatment in combination with aminophylline and followed the international guidelines for conducting systematic reviews. The outcomes measured were morbidity, escalation of care, length of hospital stay, adverse events, mortality and lung functions. We used the random-effects model for data analysis and the fixed-effects model to evaluate heterogeneity. Results Nine studies (466 participants) fulfilled our a priori eligibility criteria. No significant difference was found in post-treatment asthma severity score (mean difference (MD)=0.13, 95% CI −0.79 to 1.06, I 2 =0 %), hospitalisation rate (risk ratio (RR)=0.66, 95% CI 0.27 to 1.59, I 2 =0 % ), paediatric intensive care unit admission (RR=0.73, 95% CI 0.51 to 1.05, I 2 =0%), intubation rate (RR=0.09, 95% CI 0.01 to 1.64, p=0.1) or length of hospital stay (MD=−3.62, 95% CI −13.05 to 5.82, I 2 =31%). Emesis (RR=3.52, 95% CI 2.04 to 6.06, I 2 =0%) and nausea (RR=4.92, 95% CI 2.41 to 10.06, I 2 =0%) occurred more in the aminophylline group. One study showed improved lung function in the aminophylline group, while others showed no difference. Conclusion This review showed limited evidence of the benefit of intravenous aminophylline in managing asthma in most preventilation severity parameters. However, lowering the intubation rate and improving lung function deserve more attention. PROSPERO registration number CRD42023405234.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.016 | 0.039 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.032 | 0.040 |
| Bibliometrics | 0.008 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".