What are the effects of early use of inhaled corticosteroids in people attending the emergency department with acute asthma exacerbations?

2013 ◽  
Keyword(s):  
Emergency Department ◽  
Inhaled Corticosteroids ◽  
Acute Asthma ◽  
Asthma Exacerbations ◽  
Early Use ◽  
Acute Asthma Exacerbations

Early use of inhaled corticosteroids in the emergency department treatment of acute asthma

2003 ◽  
Author(s):  
Marcia Edmonds ◽  
Carlos A Camargo ◽  
Charles V Pollack ◽  
Brian H Rowe
Keyword(s):  
Emergency Department ◽  
Inhaled Corticosteroids ◽  
Acute Asthma ◽  
Early Use

scholarly journals Early use of inhaled corticosteroids in the emergency department treatment of acute asthma

2012 ◽  
Author(s):  
Marcia L Edmonds ◽  
Stephen J Milan ◽  
Carlos A Camargo Jr ◽  
Charles V Pollack ◽  
Brian H Rowe
Keyword(s):  
Emergency Department ◽  
Inhaled Corticosteroids ◽  
Acute Asthma ◽  
Early Use

Pediatric acute asthma exacerbations: Evaluation and management from emergency department to intensive care unit

2016 ◽  
Vol 53 (6) ◽  
pp. 607-617 ◽  
Author(s):  
Brittany Pardue Jones ◽  
Geoffrey M. Fleming ◽  
Jaime Kaye Otillio ◽  
Ishan Asokan ◽  
Donald H. Arnold
Keyword(s):  
Intensive Care Unit ◽  
Emergency Department ◽  
Intensive Care ◽  
Acute Asthma ◽  
Asthma Exacerbations ◽  
Acute Asthma Exacerbations

scholarly journals A Randomized clinical Trial of Inhaled Ciclesonide for Acute Asthma.

2020 ◽  
Author(s):  
Demétrius Tierno Martins ◽  
Karla Carlos ◽  
Luciane BC Carvalho ◽  
Lucila Bizari Prado ◽  
Carolina Fransolin ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Emergency Department ◽  
Placebo Group ◽  
Randomized Clinical Trial ◽  
Acute Asthma ◽  
Respiratory Effort ◽  
Double Blind ◽  
Asthma Exacerbations ◽  
Systemic Corticosteroids ◽  
Acute Asthma Exacerbations

Abstract Background: Current guidelines for management of acute asthma exacerbations advocate the administration of short-acting bronchodilators and systemic corticosteroids. The use of inhaled corticosteroids for this purpose has been tested since the 1990s, but the optimal agent, dose, and strategy have yet to be defined. Within the context, we designed a double-blind, randomized clinical trial aiming to compare high doses of inhaled ciclesonide to systemic corticosteroids in the treatment of acute asthma exacerbations in the emergency department. Methods: This double-blind, randomized clinical trial enrolled 58 patients with a clinical diagnosis of bronchial moderate and severe asthma by GINA(Global Initiative for Asthma) criteria who presented to the emergency department with peak flow <50% of predicted. Patients were randomized into two groups. Over the course of 4 hours, one group received 1440 mcg inhaled ciclesonide plus hydrocortisone-identical placebo (ciclesonide + placebo group), while the other received 500 mg intravenous hydrocortisone plus ciclesonide-identical placebo (hydrocortisone + placebo group). Both groups received short-acting bronchodilators (fenoterol hydrobromide and ipratropium bromide) as recommended by GINA. The research protocol included spirometry, rigorous and frequent clinical evaluation (dyspnea, accessory muscle use, wheezing, respiratory effort), and vital signs and ECG monitoring. Data were obtained at baseline, 30, 60, 90, 120, 180, and 240 minutes. We compared data from baseline to hour 4 between and within groups. Results: Overall, 31 patients received ciclesonide + placebo and 27 received hydrocortisone + placebo. Inhaled ciclesonide was as effective as intravenous hydrocortisone in improving clinical parameters (Borg-scored dyspnea, p=0.95; sternocleidomastoid muscle use, p=0.55; wheezing, p=0.55; respiratory effort, p=0.95) and spirometric parameters (forced vital capacity, p=0.50; forced expiratory volume in the first second, p=0.83; peak expiratory flow, p=0.51).Conclusions: Inhaled ciclesonide was non-inferior to systemic hydrocortisone for management of acute asthma exacerbations, improving both clinical and spirometric parameters.Trial registration: RBR-6XWC26 - Registro Brasileiro de Ensaios Clínicos (http://www.ensaiosclinicos.gov.br/rg/RBR-6xwc26/). Date of registration: 05/01/2016 'retrospectively registered'.

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