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. 1992 Aug;47(8):588–591. doi: 10.1136/thx.47.8.588

Controlled trial of intravenous corticosteroids in severe acute asthma.

F Morell 1, R Orriols 1, J de Gracia 1, V Curull 1, A Pujol 1
PMCID: PMC463918  PMID: 1412113

Abstract

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 mg/kg every four hours for 48 hours (29 patients, group A); intravenous methylprednisolone 2 mg/kg every 4 hours for 48 hours (27 patients, group B); or no intravenous corticosteroids (26 patients, group C). RESULTS: There were no differences on admission among the three groups in forced expiratory volume in one second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF), or arterial oxygen or carbon dioxide tension; and the rates of recovery in FEV1, FVC, and PEF were similar. CONCLUSIONS: Corticosteroids given with bronchodilators have not shown a beneficial effect in the first 48 hours of recovery of severe acute asthma. Only in those patients who failed to respond by the third hour of treatment, and in those who were previously taking oral corticosteroids, does a favourable, though not statistically significant, effect appear to occur.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Collins J. V., Clark T. J., Brown D., Townsend J. The use of corticosteroids in the treatment of acute asthma. Q J Med. 1975 Apr;44(174):259–273. [PubMed] [Google Scholar]
  2. Collins J. V., Clark T. J., Harris P. W., Townsend J. Intravenous corticosteroids in treatment of acute bronchial asthma. Lancet. 1970 Nov 21;2(7682):1047–1049. doi: 10.1016/s0140-6736(70)90283-7. [DOI] [PubMed] [Google Scholar]
  3. Dugué P., Orehek J., Arnaud A., Charpin J. Effet d'une injection d'hydrocortisone sur l'obstruction bronchique de l'asthme. Bull Eur Physiopathol Respir. 1977 Sep-Oct;13(5):619–627. [PubMed] [Google Scholar]
  4. Fanta C. H., Rossing T. H., McFadden E. R., Jr Glucocorticoids in acute asthma. A critical controlled trial. Am J Med. 1983 May;74(5):845–851. doi: 10.1016/0002-9343(83)91076-8. [DOI] [PubMed] [Google Scholar]
  5. Harfi H., Hanissian A. S., Crawford L. V. Treatment of status asthmaticus in children with high doses and conventional doses of methylprednisolone. Pediatrics. 1978 Jun;61(6):829–831. [PubMed] [Google Scholar]
  6. Haskell R. J., Wong B. M., Hansen J. E. A double-blind, randomized clinical trial of methylprednisolone in status asthmaticus. Arch Intern Med. 1983 Jul;143(7):1324–1327. [PubMed] [Google Scholar]
  7. Littenberg B., Gluck E. H. A controlled trial of methylprednisolone in the emergency treatment of acute asthma. N Engl J Med. 1986 Jan 16;314(3):150–152. doi: 10.1056/NEJM198601163140304. [DOI] [PubMed] [Google Scholar]
  8. Loren M. L., Chai H., Leung P., Rohr C., Brenner A. M. Corticosteroids in the treatment of acute exacerbations of asthma. Ann Allergy. 1980 Aug;45(2):67–71. [PubMed] [Google Scholar]
  9. Luksza A. R. A new look at adult asthma. Br J Dis Chest. 1982 Jan;76(1):11–14. [PubMed] [Google Scholar]
  10. Luksza A. R. Acute severe asthma treated without steroids. Br J Dis Chest. 1982 Jan;76(1):15–19. [PubMed] [Google Scholar]
  11. MacDonald J. B., MacDonald E. T., Seaton A., Williams D. A. Asthma deaths in Cardiff 1963-74: 53 deaths in hospital. Br Med J. 1976 Sep 25;2(6038):721–723. doi: 10.1136/bmj.2.6038.721. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. McFadden E. R., Jr, Kiser R., deGroot W. J., Holmes B., Kiker R., Viser G. A controlled study of the effects of single doses of hydrocortisone on the resolution of acute attacks of asthma. Am J Med. 1976 Jan;60(1):52–59. doi: 10.1016/0002-9343(76)90533-7. [DOI] [PubMed] [Google Scholar]
  13. Mitenko P. A., Ogilvie R. I. Rational intravenous doses of theophylline. N Engl J Med. 1973 Sep 20;289(12):600–603. doi: 10.1056/NEJM197309202891202. [DOI] [PubMed] [Google Scholar]
  14. Stein L. M., Cole R. P. Early administration of corticosteroids in emergency room treatment of acute asthma. Ann Intern Med. 1990 Jun 1;112(11):822–827. doi: 10.7326/0003-4819-112-11-822. [DOI] [PubMed] [Google Scholar]
  15. Tanaka R. M., Santiago S. M., Kuhn G. J., Williams R. E., Klaustermeyer W. B. Intravenous methylprednisolone in adults in status asthmaticus. Comparison of two dosages. Chest. 1982 Oct;82(4):438–440. doi: 10.1378/chest.82.4.438. [DOI] [PubMed] [Google Scholar]
  16. Younger R. E., Gerber P. S., Herrod H. G., Cohen R. M., Crawford L. V. Intravenous methylprednisolone efficacy in status asthmaticus of childhood. Pediatrics. 1987 Aug;80(2):225–230. [PubMed] [Google Scholar]

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