A Double-Blind Trial of Corticosteroid Therapy in Status Asthmaticus

Pierson, William E.; Blerman, C. Warren; Kelley, Vincent C.

doi:10.1097/00132586-197604000-00014

Cited by 25 publications

(36 citation statements)

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“…to a specific cytoplasmic receptor protein in the Another controlled study on glucocorticoid target cell. The steroid-receptor complex is therapy was carried out by Pierson et al (101) transported to the nucleus, bound to the on 45 children in status asthmaticus. Fifteen genome, where it induces the production of a children received placebos and 30 glucocortispecific messenger-RNA which is transported coids.…”

Section: Intravenous Aminophylline and Intravenousmentioning

confidence: 99%

“…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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The Treatment of Status Asthmaticus

Georg

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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Section: Intravenous Aminophylline and Intravenousmentioning

confidence: 99%

Section: Intravenous Aminophylline and Intravenousmentioning

confidence: 99%

The Treatment of Status Asthmaticus

Georg

1981

Allergy

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“…Varios autores han probado el beneficio de la asociación de beta-2 agonistas y corticoides en el asma aguda (10)(11)(12)(13)(14), así como el uso de estos últimos en forma temprana ayuda a la terminación rápida de un ataque moderado a severo de asma (10,13,31), disminuyendo además (10,14,32,33). Recientemente se ha demostrado que esta combinación es más efectiva que la asociación de un beta-2 agonista con aminofilina endovenosa en la resolución de crisis de asma en niños (34).…”

Section: Discussionunclassified

“…No se evidenciaron efectos colaterales atribuíbles al corticoide (debilidad muscular, alteraciones psicológicas) a las dosis usadas (11,12).…”

Section: Discussionunclassified

Efecto broncodilatador de fenoterol y salbutamol asociados a un corticoide en niños con crisis de asma.

Huaman¹,

Velasco²,

Vargas³

et al. 2013

Rev Med Hered

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Objetivo: Evaluar los efectos clínicos y colaterales de Fenoterol 100 ug/inh en microdosificador inhalatorio (MDI) con aerocámara y salbutamol 100 ug/inh en MDI con aerocámara ambos asociados a dexametasona endovenosa (0.3 mg/kg) en bolo. Material y métodos: En un estudio prospectivo, randomizado, multicéntrico se incluyó 60 niños con crisis asmática leve-moderada (30 para cada grupo). Ambos grupos fueron comparables en la evaluación inicial. Resultados: Fenoterol – Dexametasona dio mayor reducción del puntaje clínico (p<0.05) que Salbutamol - Dexametasona al minuto 120 (-2.86 vs -1.25 respectivamente). Asimismo un mayor aumento del Pico Espiratorio Forzado (PEF) (p<0.05) al minuto 60 en comparación a Salbutamol – Dexametasona (135 vs 54 respectivamente). Tanto para frecuencia respiratoria como para presencia de tremor los 2 grupos fueron comparables en todos los momentos de la evaluación. No se encontró diferencia significativa entre ambos grupos en la cantidad de altas al final del estudio (4 horas). Conclusiones: Concluímos que las combinaciones Fenoterol – Dexametasona y Salbutamol –Dexametasona son igualmente efectivas en el manejo de crisis asmática leves a moderadas en niños.

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“…El estudio de prevención de asma precoz en niños (PEAK) mostró que los niños con API positivo que recibían tratamiento diario con fluticasona presentaron una mejoría clínica significativa comparado con los que recibieron placebo. 4 Las limitaciones de este estudio son que fue realizado en niños más grandes (con una edad media de 3 ± 0,6 años) y que los que presentaban el API negativo fueron excluidos.…”

Section: Wheezing In Infants: Can We Separate the Wheat From The Chaff?unclassified

Valoración de la dificultad respiratoria en lactantes

Ferrero¹

2013

Arch Argent Pediat

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A Double-Blind Trial of Corticosteroid Therapy in Status Asthmaticus

Cited by 25 publications

References 0 publications

The Treatment of Status Asthmaticus

The Treatment of Status Asthmaticus

Efecto broncodilatador de fenoterol y salbutamol asociados a un corticoide en niños con crisis de asma.

Valoración de la dificultad respiratoria en lactantes

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