To The Editor:—
Unfortunately Dr. Safar's excellent review1 contained a serious misprint that could lead to aminophylline intoxication in both adults and children. The dose should have read "5-10 mg/kg/12 hrs" instead of "per gram." Yet, an occasional child needs and can tolerate 1 mg/kg/hr2 for a few hours. If none had been received previously, 2 to 3 milligrams/kg could be given over a ten-minute period to establish a therapeutic blood level.Moreover, personal experience suggests that children, at least, require 4 mEq/kg/hr of sodium bicarbonate to correct their mixed respiratory and metabolic acidosis. The rationale for this clinical observation and dose is supported by the experimental demonstration that epinephrine is more effective at a pH of 7.4 (Fed Proc, 28:481, 1969).
Mansmann HC. Aminophylline Dosage. JAMA. 1969;209(8):1224. doi:10.1001/jama.1969.03160210056025