A controlled study of the effects of single doses of hydrocortisone on the resolution of acute attacks of asthma

McFadden, E. R.; Kiser, Roger; deGroot, William J.; Holmes, Beverly; Kiker, Ronald; Viser, George

doi:10.1016/0002-9343(76)90533-7

Cited by 118 publications

(31 citation statements)

References 22 publications

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“…5 Fanta et al,6 however, found significant differences in the response to treatment over 24 hours in patients with severe acute asthma between those who were given intravenous hydrocortisone and those who were not. The study included only patients who had not responded to treatment with bronchodilators during the previous eight hours.…”

Section: Discussionmentioning

confidence: 99%

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Controlled trial of intravenous corticosteroids in severe acute asthma.

Morell

Orriols

Gracia

et al. 1992

Thorax

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Background The value of corticosteroids in severe acute asthma continues to be debated. Methods Ninety consecutive patients admitted to the emergency room with severe acute asthma were studied in a randomised, double blind, controlled trial to determine the efficacy of corticosteroids. Eighty two patients completed the study. All received oxygen therapy and intensive bronchodilator treatment. The patients were divided into three groups for steroid treatment, receiving intravenous methylprednisolone 10

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Section: Discussionmentioning

confidence: 99%

“…Spirometry was repeated every hour for the first six hours, and arterial blood gases were measured at the end of the sixth hour. All tests were then repeated at 24 Results Patients' data on entry to the study are shown in the table. The three groups were similar in all the variables measured.…”

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confidence: 99%

Controlled trial of intravenous corticosteroids in severe acute asthma.

Morell

Orriols

Gracia

et al. 1992

Thorax

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“…Patients who respond poorly to the treatment described above, and patients who despite some initial improvement continue to expe- High doses of intravenous corticosteroids should be administered immediately to the following patients: patients who show an insuffi cient therapeutic response to inhaled ␤ 2 -agonists and a drip infusion of aminophylline; patients whose condition is further deteriorating, as evidenced by grunting, disturbing of consciousness, increasingly severe dyspnea, and/or signs of circulatory failure; and patients who have required large doses of corticosteroids for previous asthma attacks. Hydrocortisone 5-7 mg/kg [130] , methylprednisolone 1-1.5 mg/kg [131] , or prednisolone 1-1.5 mg/kg are given by slow intravenous administration every 4-6 h depending on the patient's status. The mineralocorticoid effects of hydrocortisone cause edema due to sodium retention, so if treatment is continued for more than 3 days it is best to switch to another drug.…”

Section: Treatment Of Severe Attacksmentioning

confidence: 99%

Pharmacologic Control of Asthma

Makino

Adachi²,

Agō³

et al. 2005

Int Arch Allergy Immunol

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“…No was terminated, and these patients obviously such effect was evident in the three studies on did not have severe asthma. Their major im-children in status asthmaticus (59,72,101), and provements in lung function tests were seen at children may perhaps differ from adult asthma-1-2 h, i.e. before any effect of hydrocortisone tics with regard to this action of the glucocortiwould be evident.…”

Section: Intravenous Aminophylline and Intravenousmentioning

confidence: 99%

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1981

Allergy

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Asthma has proved difficult to define (42, 103, in asthma often comes suddenly and unexpect-116) and physicians do not always agree about edly, and even experienced physicians may when a patient should be called asthmatic, have difficulty in judging the severity of an Status asthmaticus cannot be easier to define, attack. The patient may be a better judge in but it seems much more seldom that physicians this respect (122), but many asthmatics are not disagree about a diagnosis of status asthma-very sensitive to changes in airway obstruction, ticus. The term will be used here to denote a Rubinfeld & Pain (111) found that 15% were sustained attack of severe asthma that has not unable to sense a reduction in FEVj below 50% responded to the treatment administered by of predicted value. An objective assessment the patient and his doctor. It is a serious and ought usually to be the first step taken when potentially lethal phase of the disease and if dealing with a patient in status asthmaticus. It hospital admission is possible it will usually be can be carried out in a few minutes, and it required.provides both a baseline from which the proStatus asthmaticus is an acute aggravation gress of the patient can be assessed and a gradwhich may afflict the allergic as well as the ing of the severity of the attack, non-allergic asthmatic. It may occur at any age.The physical signs of wheezing, the use of but the risk seems to be greatest in the middle-accessory respiratory muscles and the presence aged patient with asthma of late onset. It also of pulsus paradoxus have not been found to be seems to afflict women more often than men. reliable indicators of the severity of asthma (71, In seven recent papers (7,25,58,61,70,118,121). 119) out of a total of 1,540 patients, 1,136 were Counting the heart rate is the simplest of females and 404 males, i.e. a ratio of about 3:1.objective measurements and will provide some We have now fairly good knowledge of the indication of the severity of the attack. An elecliberation of mediator substances from the trocardiogram and a chest radiograph should mast cell in the reaction with specific allergens also be available. Tachycardia is always a feature and about their possible significance in acute, of severe asthma and is related to the degree of asthmatic attacks. Yet we do not understand hypoxaemia (107). The average heart rate is what happens when the patient lapses into about [120][121][122][123][124][125][126][127][128][129][130] found an average status asthmaticus despite the use of the medi-rate of 126; Westerman (137) 139 with a range cation which in other situations has successfully from 110 to 180; Rees (107) 118, range 96-160. brought him relief Cooke et al. (25) found a heart rate above 90 in 87% of their patients and that 75% of the complications occurred in patients with a heart Objective assessment ^ , ,0•^ rate above 130. The treatment of severe asthma must reasonTwo important objective measurements that ably begin with an assessment of severity. Death any emergency ward s...

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A controlled study of the effects of single doses of hydrocortisone on the resolution of acute attacks of asthma

Cited by 118 publications

References 22 publications

Controlled trial of intravenous corticosteroids in severe acute asthma.

Controlled trial of intravenous corticosteroids in severe acute asthma.

Pharmacologic Control of Asthma

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