Abstract
Study objective: To determine whether oral corticosteroids are significantly better at preventing the need for hospital admission than IV corticosteroids in children with moderate to severe asthma exacerbation. Methods: We carried out a randomized, double-blind, controlled trial of patients in the emergency department of a tertiary urban children's hospital. Patients who presented to the ED with moderate to severe asthma (defined as forced expiratory volume in 1 second [FEV1] < 60% predicted for height in patients aged 7 to 18 years and as Pulmonary Index Score [PIS] between 6 and 11 for patients aged 18 months through 6 years). Patients were randomized to receive 2 mg/kg oral methylprednisolone or 2 mg/kg IV methylprednisolone 30 minutes after the initial treatment with nebulized albuterol. Each patient was otherwise treated with an identical regimen of frequent nebulized albuterol and IV theophylline for a total of 4 hours. Results: Forty-nine patients were enrolled. Four hours after treatment, both groups had similar respiratory rates, oxygen saturation, PISs, and FEV1 values. Eleven of 23 patients in the oral group (48%) and 13 of 26 patients in the IV group (50%) were admitted to the hospital (P=.88). The 90% confidence interval for the 2% difference in admission rate to the hospital (favoring oral methylprednisolone) ranged from 21% (favoring IV methylprednisolone) to 25% (favoring oral methylprednisolone). Patients discharged home demonstrated greater improvement from baseline with regard to PIS and FEV1 than patients who were admitted. Two patients in each group failed to complete the standard treatment or returned to the hospital within 48 hours of ED discharge. Conclusion: These data suggest that for children with rood moderate to severe asthma exacerbation, hospital admission rates are similar in children given oral methylprednisolone and those given IV methylprednisolone.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 212-217 |
| Number of pages | 6 |
| Journal | Annals of Emergency Medicine |
| Volume | 29 |
| Issue number | 2 |
| State | Published - 1997 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Emergency Medicine
Cite this
Intravenous versus oral corticosteroids in the management of acute asthma in children. / Barnett P., L. J.; Caputo, G. L.; Baskin, M.; Kuppermann, Nathan.
In: Annals of Emergency Medicine, Vol. 29, No. 2, 1997, p. 212-217.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Intravenous versus oral corticosteroids in the management of acute asthma in children
AU - Barnett P., L. J.
AU - Caputo, G. L.
AU - Baskin, M.
AU - Kuppermann, Nathan
PY - 1997
Y1 - 1997
N2 - Study objective: To determine whether oral corticosteroids are significantly better at preventing the need for hospital admission than IV corticosteroids in children with moderate to severe asthma exacerbation. Methods: We carried out a randomized, double-blind, controlled trial of patients in the emergency department of a tertiary urban children's hospital. Patients who presented to the ED with moderate to severe asthma (defined as forced expiratory volume in 1 second [FEV1] < 60% predicted for height in patients aged 7 to 18 years and as Pulmonary Index Score [PIS] between 6 and 11 for patients aged 18 months through 6 years). Patients were randomized to receive 2 mg/kg oral methylprednisolone or 2 mg/kg IV methylprednisolone 30 minutes after the initial treatment with nebulized albuterol. Each patient was otherwise treated with an identical regimen of frequent nebulized albuterol and IV theophylline for a total of 4 hours. Results: Forty-nine patients were enrolled. Four hours after treatment, both groups had similar respiratory rates, oxygen saturation, PISs, and FEV1 values. Eleven of 23 patients in the oral group (48%) and 13 of 26 patients in the IV group (50%) were admitted to the hospital (P=.88). The 90% confidence interval for the 2% difference in admission rate to the hospital (favoring oral methylprednisolone) ranged from 21% (favoring IV methylprednisolone) to 25% (favoring oral methylprednisolone). Patients discharged home demonstrated greater improvement from baseline with regard to PIS and FEV1 than patients who were admitted. Two patients in each group failed to complete the standard treatment or returned to the hospital within 48 hours of ED discharge. Conclusion: These data suggest that for children with rood moderate to severe asthma exacerbation, hospital admission rates are similar in children given oral methylprednisolone and those given IV methylprednisolone.
AB - Study objective: To determine whether oral corticosteroids are significantly better at preventing the need for hospital admission than IV corticosteroids in children with moderate to severe asthma exacerbation. Methods: We carried out a randomized, double-blind, controlled trial of patients in the emergency department of a tertiary urban children's hospital. Patients who presented to the ED with moderate to severe asthma (defined as forced expiratory volume in 1 second [FEV1] < 60% predicted for height in patients aged 7 to 18 years and as Pulmonary Index Score [PIS] between 6 and 11 for patients aged 18 months through 6 years). Patients were randomized to receive 2 mg/kg oral methylprednisolone or 2 mg/kg IV methylprednisolone 30 minutes after the initial treatment with nebulized albuterol. Each patient was otherwise treated with an identical regimen of frequent nebulized albuterol and IV theophylline for a total of 4 hours. Results: Forty-nine patients were enrolled. Four hours after treatment, both groups had similar respiratory rates, oxygen saturation, PISs, and FEV1 values. Eleven of 23 patients in the oral group (48%) and 13 of 26 patients in the IV group (50%) were admitted to the hospital (P=.88). The 90% confidence interval for the 2% difference in admission rate to the hospital (favoring oral methylprednisolone) ranged from 21% (favoring IV methylprednisolone) to 25% (favoring oral methylprednisolone). Patients discharged home demonstrated greater improvement from baseline with regard to PIS and FEV1 than patients who were admitted. Two patients in each group failed to complete the standard treatment or returned to the hospital within 48 hours of ED discharge. Conclusion: These data suggest that for children with rood moderate to severe asthma exacerbation, hospital admission rates are similar in children given oral methylprednisolone and those given IV methylprednisolone.
UR - http://www.scopus.com/inward/record.url?scp=0031019169&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0031019169&partnerID=8YFLogxK
M3 - Article
C2 - 9018184
AN - SCOPUS:0031019169
VL - 29
SP - 212
EP - 217
JO - Annals of Emergency Medicine
JF - Annals of Emergency Medicine
SN - 0196-0644
IS - 2
ER -