Adenosine by Susan Masino & Detlev Boison

Author:Susan Masino & Detlev Boison
Language: eng
Format: epub
Publisher: Springer New York, New York, NY

16.3.3 Clinical Use of Theophylline in SCI

Two case studies demonstrated that theophylline administration increased respiratory motor output after SCI (Ferguson et al. 1999; Bascom et al. 2005). The drug enhanced central respiratory drive and inspiratory muscle force in one patient with C5–C7 injury and a history of respiratory insufficiency (Ferguson et al. 1999). In another case study, a patient with a C5–C6 injury was weaned from ventilator support after aminophylline (a more soluble form of theophylline) treatment (Bascom et al. 2005). This particular case was rather promising since the patient had developed respiratory insufficiency after prolonged bouts of pneumonia and septicemia which had to be cleared first. In a third case study, it was demonstrated that small doses of theophylline were successfully used in three SCI patients with persistent bradycardia (Schulz-Stubner 2005). In one of the three patients, the dose of theophylline used increased respiratory rate and improved minute ventilation (Schulz-Stubner 2005). After 6 weeks, treatment with theophylline was discontinued with no further episodes of bradycardia. However, the apparent promise shown in the case studies mentioned above has not been documented in a larger patient population. In a double-blind placebo-controlled crossover study in ten patients with chronic tetraplegia, theophylline administration did not significantly improve functional outcome in the entire patient pool (Tzelepis et al. 2006). Future studies will need to thoroughly examine clinical effects of theophylline in selected SCI patients with respiratory deficits, in particular insufficiency. It is anticipated that a more rigorous screening of patients, with a particular focus on duration of injury and other underlying conditions, can provide reliable results.

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