LETTER
Aminophylline and Cardiac Arrest
Joseph Varon and
Robert E. Fromm Jr.
15 September 1993 | Volume 119 Issue 6 | Page 536
TO THE EDITOR:
We agree with Viskin and coworkers [1] that aminophylline may have a role in the management of bradyasystolic cardiac arrest [2-4]. However, optimism should be tempered by our lack of experience and the uncontrolled nature of Viskin and colleagues' experiment. It is surprising that the authors observed a response to aminophylline therapy within 30 seconds of administration, given the relatively prolonged circulation time previously documented for patients in cardiac arrest [5]. Was a central venous catheter used for administration? The absence of a control group makes it impossible to conclude with certainty that the return of spontaneous circulation resulted from aminophylline therapy. Finally, even though 11 of 15 patients with cardiac arrest refractory to epinephrine and atropine developed stable heart rhythms after therapy, 10 patients died within 4 to 15 days after resuscitation. Whether aminophylline therapy actually affects ultimate outcome remains uncertain.
1. Viskin S, Belhassen B, Roth A, Reicher M, Averbuch M, Sheps D, et al. Aminophylline for bradyasystolic cardiac arrest refractory to atropine and epinephrine. Ann Intern Med. 1993; 118:279-81.
2. Orlowski JP. Pediatric cardiopulmonary resuscitation. Emerg Med Clin North Am. 1983; 1:3-25.
3. Muthu P, Krishnamoorthy MS, Kumaravel TS. Effect of aminophylline preperfusion on digoxin-induced cardiac arrest in isolated frog heart. Indian J Exp Biol. 1991; 29:870-1.
4. Tomcsanyi J, Grosz A, Karlocai K. Abolishing a sinus arrest resistant to atropine by aminophylline. Int J Cardiol. 1990; 29:96-8.
5. Hedges JR, Barsan WB, Doan LA, et al. Central versus peripheral intravenous routes in cardiopulmonary resuscitation. Am J Emerg Med. 1984; 2:385-90.
About Letters
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
Top
References
Article
