The diuretic effect of adding aminophylline or theophylline to furosemide in pediatric populations: A systematic review
Document Type
Article
Publication Date
1-1-2023
Abstract
The diuretic effect of the combined furosemide and aminophylline/theophylline among pediatric patients remains unclear. The primary aim of this systematic review was to examine the clinical diuretic effects (urine output and fluid balance) of co-administration of furosemide and aminophylline/theophylline as compared to furosemide alone in pediatric population. Ovid MEDLINE, CENTRAL, and EMBASE were searched from its inception until March 2022 for observational studies and randomized controlled trials (RCTs) comparing the administration of furosemide versus furosemide and aminophylline/theophylline in pediatric population. Case reports, case series, commentaries, letters to editors, systematic reviews, and meta-analyses were excluded. Five articles with a total sample population of 187 patients were included in this systematic review. As compared to the furosemide alone, our pooled data demonstrated that co-administration of furosemide and aminophylline/theophylline was associated with higher urine output (mean difference: 2.91 90% CI 1.54 to 4.27], p < 0.0001, I-2 = 90%) and a more negative fluid balance (mean difference - 28.27 95% CI: - 46.21 to - 10.33], p = 0.002, I-2 = 56%) than those who received furosemide alone. Conclusion: This is the first paper summarizing the evidence of combined use of furosemide with aminophylline/theophylline in pediatric population. Our systematic review demonstrated that the co-administration of furosemide and aminophylline/theophylline could potentially yield better diuretic effects of urine output and negative fluid balance than furosemide alone in pediatric patients with fluid overload. Given the substantial degree of heterogeneity and low level of evidence, future adequately powered trials are warranted to provide evidence regarding the combined use of aminophylline/theophylline and furosemide as diuretic in the pediatric population.
Keywords
Aminophylline, Critically ill, Furosemide, Pediatric, Theophylline
Divisions
anaesthesiology,paediatrics
Funders
None
Publication Title
European Journal of Pediatrics
Volume
182
Issue
1
Publisher
Springer
Publisher Location
ONE NEW YORK PLAZA, SUITE 4600, NEW YORK, NY, UNITED STATES