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Corticosteroids do not affect the clinical or physiological status of infants with bronchiolitis
C Springer1, E Bar-Yishay, K Uwayyed
1Department of Pediatrics, Hadassah University Hospital, Mount Scopus, Jerusalem, Israel.
Insights
Systemic corticosteroids combined with albuterol did not improve clinical outcomes or lung function in infants with acute bronchiolitis. This treatment approach showed no significant difference compared to albuterol and placebo for recovery or long-term lung function.
Area of Science:
- Pediatric Pulmonology
- Clinical Medicine
- Pharmacology
Background:
- Acute bronchiolits is a common respiratory infection in infants.
- The efficacy of systemic corticosteroids in treating acute bronchiolitis remains a subject of investigation.
- Current treatment guidelines often lack definitive recommendations for corticosteroid use in this condition.
Purpose of the Study:
- To evaluate the effectiveness of combined inhaled albuterol and systemic corticosteroids versus inhaled albuterol and placebo in infants with acute bronchiolitis.
- To assess the impact of this treatment on clinical improvement, hospital stay duration, and lung function.
- To determine if corticosteroids alter the course of acute bronchiolitis or subsequent lung function recovery.
Main Methods:
- A double-blind study involving 50 infants aged 1.5-11.0 months with acute bronchiolitis.
- Participants were randomized to receive either inhaled albuterol with systemic corticosteroids or inhaled albuterol with a placebo.
- Clinical scores, hospital stay, and lung function parameters (thoracic gas volume, specific airway conductance, forced expiratory flow) were measured.
Main Results:
- No significant differences were observed in the initial clinical scores or the rate of clinical improvement between the corticosteroid and placebo groups.
- Hospital stay duration was similar for both groups (5.0 +/- 1.2 days for steroids vs. 5.2 +/- 1.7 days for placebo).
- Lung function measurements in the acute and convalescent stages showed no significant differences between the treatment groups.
Conclusions:
- Systemic corticosteroids do not appear to alter the rate of clinical improvement in infants with acute bronchiolitis.
- Corticosteroid treatment did not demonstrate a significant effect on lung function parameters 2-4 weeks post-treatment.
- The findings suggest that combining systemic corticosteroids with albuterol is not beneficial for managing acute bronchiolitis in this age group.
Abstract:
The treatment of infants aged 1.5-11.0 months suffering from acute bronchiolitis with a combination of inhaled albuterol and systemic corticosteroids or inhaled albuterol and placebo was compared in 50 infants in a double blind study. The mean initial clinical score and the rate of improvement was similar in the two groups. The mean +/- SD hospital stay was 5.0 +/- 1.2 days for the steroid group and 5.2 +/- 1.7 days for the placebo group. Lung function was measured in 14 infants (7 from each group) and showed evidence of increased lung volumes and severe airway obstruction in the acute stage (the mean values for the steroid group were: TGV, 31 mL/kg; SGaw, 0.104 L/s.cmH2O; VmaxFRC, 12.9 mL/s/kg; for the placebo group: TGV, 35 mL/kg; SGaw, 0.104 L/s.cmH2O; VmaxFRC, 8.5 mL/s/kg) which had improved 2-4 weeks later (steroid group: TGV, 25 mL/kg; SGaw, 0.168 L/s.cmH2O; VmaxFRC, 21.6 mL/s/kg; -placebo group: TGV, 24 mL/kg, SGaw, 0.198 L/s.cmH2O, VmaxFRC, 17.5 mL/s/kg). There were no significant differences of thoracic gas volume, specific airway conductance, and forced expiratory flow at resting lung volume between the two groups, either in the acute or convalescent stages. We conclude that corticosteroids do not change the rate of clinical improvement in acute bronchiolitis, nor do they effect lung function 2-4 weeks later.