Practical considerations of nebulized corticosteroid in children with acute asthmatic exacerbation: A consensus
Background: Acute asthmatic exacerbation in children causes economic burdens both directly and indirectly. The GINA guideline does mention the use of inhaled or oral corticosteroids in the treatment of asthmatic exacerbation, it provides little practical guidance on the use of nebulized corticostero...
Saved in:
Main Authors: | , , , , , , , , , , , , , |
---|---|
Other Authors: | |
Format: | Article |
Published: |
2022
|
Subjects: | |
Online Access: | https://repository.li.mahidol.ac.th/handle/123456789/77238 |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
Institution: | Mahidol University |
id |
th-mahidol.77238 |
---|---|
record_format |
dspace |
spelling |
th-mahidol.772382022-08-04T16:15:13Z Practical considerations of nebulized corticosteroid in children with acute asthmatic exacerbation: A consensus Chalerat Direkwattanachai Chalermthai Aksilp Pantipa Chatchatee Orathai Jirapongsananuruk Haruthai Kamalaporn Wasu Kamchaisatian Sorasak Lochindarat Lina Ngamtrakulpanit Orapan Poachanukoon Muthita Trakultivakorn Jamaree Teeratakulpisarn Kanokporn Udomittipong Mukda Vangveeravong Jitladda Deerojanawong Ramathibodi Hospital Siriraj Hospital Faculty of Medicine, Chiang Mai University Thammasat University Hospital Faculty of Medicine, Khon Kaen University Bangkok Hospital Medical Center Thailand Ministry of Public Health Faculty of Medicine, Chulalongkorn University Immunology and Microbiology Medicine Background: Acute asthmatic exacerbation in children causes economic burdens both directly and indirectly. The GINA guideline does mention the use of inhaled or oral corticosteroids in the treatment of asthmatic exacerbation, it provides little practical guidance on the use of nebulized corticosteroid. Objective: To review and recommend the practical considerations in the use of nebulized corticosteroid in children with acute asthmatic exacerbation. Methods: This consensus was developed by a group of expert pediatricians in respiratory and allergy fields in Thailand. The recommendations were made based on a review of published studies and clinical opinions. The eligible studies were confined to those published in English, and randomized controlled trials and meta-analyses involving nebulized corticosteroids in asthmatic exacerbation in children aged between 1-18 years. Results: There were 13 randomized controlled-trial studies published from 1998 to 2017. Nine of the 13 studies compared nebulized with systemic corticosteroid conducted in moderate to severe exacerbation, while the remaining four compared nebulized corticosteroid with placebo conducted in mild to severe exacerbation. The admission rate was significantly lower in severe exacerbation (one study) and pooled four mild to severe exacerbation studies comparing with placebo (p 0.022). Other clinical parameters were significantly improved with nebulized corticosteroid such as clinical scores, systemic corticosteroid/bronchodilator use, or shorter ER stays. Only one study used fluticasone, while the other 12 studies conducted by budesonide (92.31%). Conclusion: Nebulized corticosteroid may offer an effective therapeutic option for the management of acute exacerbation of asthma in all severities. Nebulized budesonide is the preferred corticosteroid. 2022-08-04T08:48:35Z 2022-08-04T08:48:35Z 2021-09-01 Article Asian Pacific Journal of Allergy and Immunology. Vol.39, No.3 (2021), 168-176 10.12932/AP-170918-0407 22288694 0125877X 2-s2.0-85088615952 https://repository.li.mahidol.ac.th/handle/123456789/77238 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85088615952&origin=inward |
institution |
Mahidol University |
building |
Mahidol University Library |
continent |
Asia |
country |
Thailand Thailand |
content_provider |
Mahidol University Library |
collection |
Mahidol University Institutional Repository |
topic |
Immunology and Microbiology Medicine |
spellingShingle |
Immunology and Microbiology Medicine Chalerat Direkwattanachai Chalermthai Aksilp Pantipa Chatchatee Orathai Jirapongsananuruk Haruthai Kamalaporn Wasu Kamchaisatian Sorasak Lochindarat Lina Ngamtrakulpanit Orapan Poachanukoon Muthita Trakultivakorn Jamaree Teeratakulpisarn Kanokporn Udomittipong Mukda Vangveeravong Jitladda Deerojanawong Practical considerations of nebulized corticosteroid in children with acute asthmatic exacerbation: A consensus |
description |
Background: Acute asthmatic exacerbation in children causes economic burdens both directly and indirectly. The GINA guideline does mention the use of inhaled or oral corticosteroids in the treatment of asthmatic exacerbation, it provides little practical guidance on the use of nebulized corticosteroid. Objective: To review and recommend the practical considerations in the use of nebulized corticosteroid in children with acute asthmatic exacerbation. Methods: This consensus was developed by a group of expert pediatricians in respiratory and allergy fields in Thailand. The recommendations were made based on a review of published studies and clinical opinions. The eligible studies were confined to those published in English, and randomized controlled trials and meta-analyses involving nebulized corticosteroids in asthmatic exacerbation in children aged between 1-18 years. Results: There were 13 randomized controlled-trial studies published from 1998 to 2017. Nine of the 13 studies compared nebulized with systemic corticosteroid conducted in moderate to severe exacerbation, while the remaining four compared nebulized corticosteroid with placebo conducted in mild to severe exacerbation. The admission rate was significantly lower in severe exacerbation (one study) and pooled four mild to severe exacerbation studies comparing with placebo (p 0.022). Other clinical parameters were significantly improved with nebulized corticosteroid such as clinical scores, systemic corticosteroid/bronchodilator use, or shorter ER stays. Only one study used fluticasone, while the other 12 studies conducted by budesonide (92.31%). Conclusion: Nebulized corticosteroid may offer an effective therapeutic option for the management of acute exacerbation of asthma in all severities. Nebulized budesonide is the preferred corticosteroid. |
author2 |
Ramathibodi Hospital |
author_facet |
Ramathibodi Hospital Chalerat Direkwattanachai Chalermthai Aksilp Pantipa Chatchatee Orathai Jirapongsananuruk Haruthai Kamalaporn Wasu Kamchaisatian Sorasak Lochindarat Lina Ngamtrakulpanit Orapan Poachanukoon Muthita Trakultivakorn Jamaree Teeratakulpisarn Kanokporn Udomittipong Mukda Vangveeravong Jitladda Deerojanawong |
format |
Article |
author |
Chalerat Direkwattanachai Chalermthai Aksilp Pantipa Chatchatee Orathai Jirapongsananuruk Haruthai Kamalaporn Wasu Kamchaisatian Sorasak Lochindarat Lina Ngamtrakulpanit Orapan Poachanukoon Muthita Trakultivakorn Jamaree Teeratakulpisarn Kanokporn Udomittipong Mukda Vangveeravong Jitladda Deerojanawong |
author_sort |
Chalerat Direkwattanachai |
title |
Practical considerations of nebulized corticosteroid in children with acute asthmatic exacerbation: A consensus |
title_short |
Practical considerations of nebulized corticosteroid in children with acute asthmatic exacerbation: A consensus |
title_full |
Practical considerations of nebulized corticosteroid in children with acute asthmatic exacerbation: A consensus |
title_fullStr |
Practical considerations of nebulized corticosteroid in children with acute asthmatic exacerbation: A consensus |
title_full_unstemmed |
Practical considerations of nebulized corticosteroid in children with acute asthmatic exacerbation: A consensus |
title_sort |
practical considerations of nebulized corticosteroid in children with acute asthmatic exacerbation: a consensus |
publishDate |
2022 |
url |
https://repository.li.mahidol.ac.th/handle/123456789/77238 |
_version_ |
1763492319781191680 |