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[Effectiveness of short-term corticosteroid therapy in patients with acute bronchial asthma in Puerto Rico]
J L Vicéns1, M Quiñones, R M Díaz
1Departamento de Pediatría, Hospital Municipal de San Juan.
Insights
Short-term corticosteroid use in pediatric acute bronchial asthma showed a tendency to reduce hospitalizations and exacerbations. Further research with larger samples is recommended for definitive conclusions on asthma management.
Area of Science:
- Pediatric Emergency Medicine
- Pulmonology
Background:
- Acute bronchial asthma is a common pediatric respiratory illness.
- Effective short-term management strategies are crucial for pediatric emergency care.
Purpose of the Study:
- To evaluate the efficacy of short-term corticosteroid therapy in pediatric patients (5-6 years) with acute bronchial asthma.
- To assess the impact of corticosteroids on pulmonary index, peak expiratory flow rate (PEFR), and oxygen saturation.
Main Methods:
- Pilot study involving 15 pediatric patients diagnosed with acute bronchial asthma.
- Randomized controlled trial comparing corticosteroids with albuterol against albuterol alone.
- Objective assessments included pulmonary index, PEFR, and pulse oximetry at multiple time points.
- Follow-up evaluations occurred at 5-7 and 10-14 days post-discharge.
Main Results:
- Patients receiving corticosteroids showed a tendency towards improved or maintained pulmonary index, PEFR, and oxygen saturation.
- A trend indicated fewer hospitalizations and exacerbations in the corticosteroid group.
- Discharge criteria included a pulmonary index < 4, PEFR > 70%, and oxygen saturation > 95%.
Conclusions:
- Short-term corticosteroid use in pediatric acute bronchial asthma may lead to better clinical outcomes.
- The study suggests a potential benefit in reducing asthma exacerbations and hospital readmissions.
- Larger sample sizes are needed to confirm these findings and establish definitive treatment guidelines.
Abstract:
This is a pilot study realized in the San Juan City Hospital Pediatric Emergency Room to determine the efficacy of the short-term use of corticosteroids in pediatric patients (5 to 6 years old) with the diagnosis of acute bronchial asthma during the months of March to June 1992. Twenty three (23) cases were evaluated, of which, 8 cases were excluded because they did not comply with the eligibility criterias. The treatment was implemented in a random fashion, which consisted of one control group of treatment with different corticosteroids in combination with albuterol. The patients were evaluated at 0, 2, 6, 12 and 24 hr of therapy a pulmonary index, peak expiratory flow rate (PEFR) and pulse oximeter saturation. On admission to the study the average pulmonary index was 6 and PEFR of less than -3sd. When the patients achieved a pulmonary index of < 4, PEFR > 70% and pulse oxygen saturation of > 95% they were discharged. They were reevaluated at 5 to 7 days and 10 to 14 days after discharge. Using the same objective parameters patients that used corticosteroids had a tendency to improve or maintain the pulmonary index, PEFR and oxygen saturation between normal values. In this study it was possible to identify a tendency in the patients who used corticosteroids: the hospitalizations and exacerbations were less. The extension of the study in terms of population sample offers a better statistical representation to determine the real tendency or conclusions.