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By continuing to browse this site you agree to us using cookies as described in About Cookies. Patients with acute asthma treated in the emergency department ED are frequently treated with inhaled beta 2 -agonists and systemic corticosteroids after discharge. The use of inhaled corticosteroids ICS following discharge may also be beneficial in improving patient outcomes after acute asthma.
To determine the effectiveness of ICS on outcomes in the treatment of acute asthma following discharge from the ED. To quantify the effectiveness of ICS therapy on acute asthma following ED discharge, when used in addition to, or as a substitute for, systemic corticosteroids. In addition, primary authors and pharmaceutical companies were contacted to identify eligible studies.
Bibliographies from included studies, known reviews and texts also were searched. The searches have been conducted up to September Studies were included if patients were treated for acute asthma in the ED or its equivalent, and following ED discharge were treated with ICS therapy either in addition to, or as a substitute for, oral corticosteroids. Two review authors independently assessed articles for potential relevance, final inclusion and methodological quality. Data were extracted independently by two review authors, or confirmed by the study authors.
Several authors and pharmaceutical companies provided unpublished data. The data were analysed using the Cochrane Review Manager software. The primary analysis employed a fixed effect model and heterogeneity is reported using I-squared I 2 statistics. Twelve trials were eligible for inclusion. Three of these trials, involving a total of patients, compared ICS plus systemic corticosteroids versus oral corticosteroid therapy alone.
There was no demonstrated benefit of ICS therapy when used in addition to oral corticosteroid therapy in the trials. Relapses were reduced; however, this was not statistically significant with the addition of ICS therapy OR 0. In addition, no statistically significant differences were demonstrated between the two groups for relapses requiring admission, quality of life, symptom scores or adverse effects. Nine trials, involving a total of patients compared high-dose ICS therapy alone versus oral corticosteroid therapy alone after ED discharge.
There were no significant differences demonstrated between ICS therapy alone versus oral corticosteroid therapy alone for relapse rates OR 1. However, the sample size was not adequate to exclude the possibility of either treatment being significantly inferior and people with severe asthma were excluded from these trials. There is insufficient evidence that ICS therapy provides additional benefit when used in combination with standard systemic corticosteroid therapy upon ED discharge for acute asthma.
There is some evidence that high-dose ICS therapy alone may be as effective as oral corticosteroid therapy when used in mild asthmatics upon ED discharge; however, the confidence intervals were too wide to be confident of equal effectiveness.
Further research is needed to clarify whether ICS therapy should be employed in acute asthma treatment following ED discharge. The review does not suggest any reason to stop usual treatment with ICS following ED discharge, even if a course of oral corticosteroids are prescribed. Acute asthma is a common cause of visits to emergency departments ED and the majority of patients are treated and discharged home.
Some people will have a relapse of acute asthma within two weeks of being discharged after apparently successful treatment. Beta 2 -agonist drugs are used to open the muscles in the airways and corticosteroids drugs are used to reduce inflammation of the swollen airways. Corticosteroids can be inhaled ICS or swallowed as a tablet so-called oral corticosteroids.
ICS may reduce adverse effects and get to the airways more directly than oral corticosteroids. This review of trials found that there was insufficient evidence that inhaling corticosteroids as well as taking the drugs orally is better than oral use alone, after emergency department treatment for an asthma attack.
There is also insufficient evidence that taking ICS alone is as good as taking them orally, although there is some evidence to support using ICS alone for mild asthma attacks after emergency department discharge. More research is needed. Kortikosteroidi se mogu davati u vidu inhalacija inhalacjiski kortikosteroidi ili u obliku tableta tzv. Asma akut adalah penyebab lazim lawatan ke jabatan kecemasan ED dan majoriti pesakit dirawat dan dibenarkan pulang.
Sesetengah pesakit mengalami relaps asma akut dalam tempoh dua minggu selepas discaj setelah rawatan berjaya. Ubat beta 2 -agonist digunakan untuk membuka otot laluan udara dan ubat kortikosteroid digunakan untuk mengurangkan keradangan dan kebengkakan laluan udara.
Kortikosteroid boleh disedut ICS atau ditelan sebagai tablet oral kortikosteroid. ICS boleh mengurangkan kesan sampingan dan sampai terus ke laluan udara berbanding kortikosteroid oral. Ulasan ini mendapati kurang bukti bahawa sedutan kortikosteriod dan pengambilan ubat secara oral adalah lebih baik berbanding penggunaan ubat oral sahaja, selepas rawatan serangan asma di jabatan kecemasan. Terdapat juga kurang bukti pengambilan ICS sahaja adalah sama baik dengan pengambilan oral, walaupun terdapat sedikit bukti untuk menyokong penggunaan ICS sahaja bagi serangan asma ringan selepas discaj dari jabatan kecemasan.
Lebih banyak kajian diperlukan. Untuk sebarang pertanyaan berkaitan terjemahan ini sila hubungi andey usm. Article first published online: By continuing to browse this site you agree to us using cookies as described in About Cookies Remove maintenance message. Abstract Background Patients with acute asthma treated in the emergency department ED are frequently treated with inhaled beta 2 -agonists and systemic corticosteroids after discharge. Objectives To determine the effectiveness of ICS on outcomes in the treatment of acute asthma following discharge from the ED.
Data collection and analysis Data were extracted independently by two review authors, or confirmed by the study authors. Main results Twelve trials were eligible for inclusion. Authors' conclusions There is insufficient evidence that ICS therapy provides additional benefit when used in combination with standard systemic corticosteroid therapy upon ED discharge for acute asthma. English French Japanese Croatian Malay.
Plain language summary Inhaled corticosteroids for acute asthma following emergency department discharge Acute asthma is a common cause of visits to emergency departments ED and the majority of patients are treated and discharged home. Notes de traduction Translated by: French Cochrane Centre Translation supported by: Ringkasan bahasa mudah Sedutan kortikosteroid untuk asma akut selepas discaj dari jabatan kecemasan Asma akut adalah penyebab lazim lawatan ke jabatan kecemasan ED dan majoriti pesakit dirawat dan dibenarkan pulang.
Editorial Group Cochrane Airways Group. In people discharged from the emergency department following treatment for acute asthma, what are the benefits and harms of inhaled steroids?
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