Aminophylline in treatment of acute exacerbation of COPD : ACUTE study(Aminophylline in COPD- utility and Treatment effects)

The main Objective of the study is to assess safety, tolerability and clinicaleffects of aminophylline infusion in treatment of acute exacerbation of COPD

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We intend to screen all patients presenting to our respiratory ICU withlabelled COPD in an exacerbation ( as defined by GOLD) for inclusion into ourstudy for a period of 1 year from  15.7.2022 .All of these patients will be managed conventionally withstandard therapy for COPD by an independent group of treating physicians. Post72 hours, the patients will be reassessed and all patients fitting theinclusion criteria will be administered aminophylline .All patients beingadministered aminophylline will be subject to continuous ECG monitoring and 6hourly abg analysis in the 24 hour period of aminophylline administration. Atleastanother arterial blood gas analysis will be done at the end of 48 hours ofinitiation of aminophylline infusion. Dyspnoea as measured by the modified BORGscale will be evaluated by an independent respiratory therapist.

Aminophyllineis an old and inexpensive drug which is known for its pleotropic action andsynergism with inhaled bronchodilators. It has fallen into disfavour due to itspronounced adverse effects. We believe when administered to the right sub groupof patients the benefits far out weigh the risks, and it may prove a worthysalvage option for critically ill patients.