The purpose of the study is compare the effects of peri-operative administration of
aminophylline (non-specific adenosine receptor antagonist) versus saline placebo in the
preservation of renal function and the attenuation of renal injury in newborns, and young
infants following cardiac palliative/correction surgery.
The study rationale is Aminophylline and theophylline are competitive non-selective
inhibitors of adenosine. Therefore, even though aminophylline infusion (iv) has no effect on
renal blood flow rate at baseline, it can ameliorate the decrease in renal blood flow rate
following adenosine infusion. This property can improve renal function when the main
mechanism of insult induces vasoconstriction. Both early and late administration of
aminophylline protects renal function after ischemia-reperfusion injury in rats.
Aminophylline has also been reported to successfully reverse newborn renal failure, prevent
renal failure in perinatal asphyxia, and reverse acute kidney injury secondary to calcineurin
induced nephropathy. Both theophylline and aminophylline have been used for prophylaxis of
renal impairment during aorto-coronary bypass surgery in adults and the results have not been
consistent for either a positive or negative effect. There have been no trials reported on
the effect of aminophylline or theophylline to prevent or ameliorate acute kidney injury in
children with congenital heart defects going through cardiac surgery.