scholarly journals Physician and parent barriers to the use of oral corticosteroids for the prevention of paediatric URTI-induced acute asthma exacerbations at home

2017 ◽  
Vol 22 (4) ◽  
pp. 190-194 ◽  
Author(s):  
Neale Smith ◽  
Anne Smith ◽  
Alice Wang ◽  
Kaitlyn Shaw ◽  
Gabriella Groeneweg ◽  
...  
Keyword(s):  
Acute Asthma ◽  
Asthma Exacerbations ◽  
Oral Corticosteroids ◽  
Acute Asthma Exacerbations ◽  
At Home

Intravenous versus Oral Corticosteroids for Treatment of Acute Asthma Exacerbations

2002 ◽  
Vol 36 (4) ◽  
pp. 565-570 ◽  
Author(s):  
Patricia Pecora Fulco ◽  
Amista A Lone ◽  
Carol B Pugh
Keyword(s):  
Medical History ◽  
Flow Rate ◽  
Peak Expiratory Flow Rate ◽  
Asthma Exacerbation ◽  
Acute Asthma ◽  
Past Medical History ◽  
Asthma Exacerbations ◽  
Acute Asthma Exacerbation ◽  
Oral Corticosteroids ◽  
Acute Asthma Exacerbations

OBJECTIVE: To compare the duration of hospitalization of patients treated with either oral or intravenous corticosteroids for an acute asthma exacerbation. METHODS: A retrospective chart review was performed on a random sample of inpatients. Patients were included with the following: a discharge diagnosis of an acute asthma exacerbation, a past medical history significant for asthma, age between 16 and 60 years, and treatment with either oral or intravenous corticosteroids at the time of admission. Exclusion criteria included: patients receiving chronic prednisone therapy, a past medical history significant for chronic obstructive pulmonary disease, an admission to the intensive care unit, or a consistent smoking habit of at least 1 pack daily. Length of hospitalization was the primary outcome measured. Secondary outcomes included 24-hour peak expiratory flow rate, 24-hour pulse oximetry (pO2), and amount of β-agonist and ipratropium used. RESULTS: Fifty-three patients were included in the final data analysis. Patients were grouped by route of corticosteroid administration (intravenous or oral). No significant differences were noted between the 2 groups for race, gender, age, height, weight, admission peak expiratory flow rate, admission pO2, or types of asthma medications used prior to admission. No significant differences were demonstrated in any of the outcome measures. CONCLUSIONS: Both the intravenous and oral corticosteroid groups demonstrated similar clinical outcomes and lengths of hospitalization in the treatment of acute asthma exacerbations. These results support the initial use of oral corticosteroids for the treatment of acute asthma exacerbations in adult patients admitted to a general medical service.

Effectiveness of Inhaled Corticosteroids in Controlling Acute Asthma Exacerbations in Children at Home

2001 ◽  
Vol 40 (2) ◽  
pp. 79-86 ◽  
Author(s):  
Benjamin Volovitz ◽  
Moshe Nussinovitch ◽  
Yaron Finkelstein ◽  
Liora Harel ◽  
Itzhak Varsano
Keyword(s):  
Inhaled Corticosteroids ◽  
Acute Asthma ◽  
Asthma Exacerbations ◽  
Acute Asthma Exacerbations ◽  
At Home

Survey of physicians’ attitudes toward the use of magnesium sulfate for acute asthma exacerbations in Turkey

2016 ◽  
Vol 53 (5) ◽  
pp. 525-531 ◽  
Author(s):  
Ayşe Baççıoğlu ◽  
Arzu Bakırtaş ◽  
Ferda Öner Erkekol ◽  
Ömer Kalaycı ◽  
Sevim Bavbek
Keyword(s):  
Magnesium Sulfate ◽  
Acute Asthma ◽  
Asthma Exacerbations ◽  
Acute Asthma Exacerbations

Oral Dexamethasone to Control Wheezing in Children at an Outpatient Clinic

2018 ◽  
Vol 58 (2) ◽  
pp. 151-158 ◽  
Author(s):  
Angela S. Volk ◽  
Stephanie A. Marton ◽  
Brittany S. Richardson ◽  
Luis Rauda ◽  
Heidi L. Schwarzwald ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Acute Asthma ◽  
Hospital Setting ◽  
Retrospective Chart Review ◽  
Office Visit ◽  
Asthma Exacerbations ◽  
Oral Dexamethasone ◽  
Cost Effective Treatment ◽  
Ed Visits ◽  
Acute Asthma Exacerbations

Asthma, a chronic childhood disease, has resulted in increased emergency department (ED) visits with high costs. Many asthma ED visits are nonemergent and could be treated in outpatient clinics. Literature has concluded that a 2-day course of oral dexamethasone has comparable outcomes to a 5-day course of prednisone in the ED and hospital setting. A retrospective chart review was performed on children requiring in-house treatment with a corticosteroid (dexamethasone n = 23, prednisone n = 40) for acute asthma exacerbations at an ambulatory medical home. The rates of hospital admissions, ED visits, and symptom follow-up were similar between the 2 groups ( P > .05). The cost for a course of dexamethasone was US$1.28 versus US$16.20 for prednisolone. The average cost for an asthma exacerbation office visit was US$79.89 compared with US$3113.28 for an ED visit. A 2-day course of oral dexamethasone appears to be a promising clinical and cost-effective treatment for acute asthma exacerbations at the primary care level.

The Utility of Albuterol Nebulized With Heliox during Acute Asthma Exacerbations

2003 ◽  
Vol 41 (5) ◽  
pp. 766-767
Author(s):  
JP Kress ◽  
I Noth ◽  
BK Gehlbach ◽  
RK Cydulka
Keyword(s):  
Acute Asthma ◽  
Asthma Exacerbations ◽  
Acute Asthma Exacerbations

Dexamethasone Versus Prednisone in Children Hospitalized for Acute Asthma Exacerbations

2021 ◽  
Vol 11 (11) ◽  
pp. 1263-1272
Author(s):  
Sunita Ali Hemani ◽  
Brianna Glover ◽  
Samantha Ball ◽  
Willi Rechler ◽  
Martha Wetzel ◽  
...  
Keyword(s):  
Acute Asthma ◽  
Asthma Exacerbations ◽  
Acute Asthma Exacerbations

Severe Acute Asthma in a Pediatric Intensive Care Unit: Six Years' Experience

PEDIATRICS ◽  
1989 ◽  
Vol 83 (6) ◽  
pp. 1023-1028
Author(s):  
Renato Stein ◽  
Gerard J. Canny ◽  
Desmond J. Bohn ◽  
Joseph J. Reisman ◽  
Henry Levison
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Severe Asthma ◽  
Acute Asthma ◽  
Mortality And Morbidity ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Oral Corticosteroids ◽  
Severe Acute Asthma ◽  
At Home

The management of children with severe acute asthma who required admission to the intensive care (ICU) of this hospital during 1982 to 1988 was reviewed retrospectively. A total of 89 children were admitted to the ICU on 125 occasions. During the study period, 24% of the patients were admitted to the ICU on more than one occasion. Prior to admission to this hospital, patients had been symptomatic for a mean of 48 hours. Although all patients had received bronchodilators before admission to hospital, only 23% of patients had received oral corticosteroids. According to initial arterial blood gas values determined in the ICU, 77% of the patients had hypercapnia (PaCO2 >45 mm Hg). The pharmacologic agents used in the ICU included nebulized β2agonists (100% of admissions), theophylline (99%), steroids (94%), nebulized ipratropium bromide (10%), IV albuterol (38%), and IV isoproterenol (10%). Mechanical ventilation was necessary in 33% of admissions; the mean duration of ventilation was 32 hours. Ten patients had pneumothorax; in six cases, these were related to mechanical ventilation. Three of the patients who received mechanical ventilation died, representing a mortality of 7.5%. In each of these patients, sudden, severe asthma episodes had developed at home, resulting in respiratory arrest. They had evidence of hypoxic encephalopathy at the time of admission to the ICU and eventually were declared brain dead. It was concluded that delay in seeking medical care and underuse of oral corticosteroids at home may have contributed to the need for ICU admission. The mortality and morbidity for children with severe asthma who require ICU admissions are small, provided that bronchodilators and IV steroids are used optimally and that patients who require mechanical ventilation are carefully selected.

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