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Role of corticosteroids in acute exacerbations of chronic obstructive pulmonary disease
1Pulmonary Section, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota 55417, USA. niewo001@tc.umn.edu
Abstract:
Systemic corticosteroid therapy for patients with exacerbations of chronic obstructive pulmonary disease has become increasingly commonplace over the past two decades. This practice was controversial because a number of small clinical trials provided inconclusive evidence about efficacy. Experience from recent trials indicates that systemic cortico-steroids are modestly effective in this setting. Systemic corticosteroids administered to hospitalized patients reduces the absolute treatment rate by about 10%, increases the forced expiratory volume in 1 second (FEV(1)) by about 100 mL, and shortens the hospital stay by 1 to 2 days. Treatment should not extend longer than 2 weeks. The optimal starting dose is not known. Hyperglycemia and possibly an increased rate of secondary infections are expected complications of treatment.
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