TY - JOUR
T1 - Early corticosteroid use in acute exacerbations of chronic airflow obstruction
AU - Bullard, Michael J.
AU - Liaw, Shiumn Jen
AU - Tsai, Ying Huang
AU - Min, Hu Pai
PY - 1996
Y1 - 1996
N2 - To determine the benefit of early steroid use in acute exacerbations of chronic airflow obstruction in the ED, 113 patients with an average age of 66 years, acute or chronic dyspnea, an FEV1 of <60% and FEV1/FVC ratio of <60% were included in a randomized, double-blinded, interventional clinical trial. All patients received the same bronchodilator treatment. At 6 hours the steroid-treated group showed a 21.71 L/min improvement in PEFR (P < .05) and 0.14 L improvement in FEV1 (P < .05), while the nonsteroid group showed insignificant improvements of 5.52 L/min and 0.02 L, respectively. Of those patients receiving steroids, 22 achieved >40% improvements in PEFR by 6 hours and 17 achieved similar results in FEV1, whereas of those not receiving steroids, 13 and 8, respectively, achieved improvements. Within 24 hours of observation in the ED, 10 patients receiving steroids were discharged and none relapsed within 2 weeks. Of those not receiving steroids, only 10 were discharged and 3 returned with exacerbations. Although early response to steroids in chronic airflow obstruction is variable, the overall medical and cost benefits justify their early use in acute exacerbations.
AB - To determine the benefit of early steroid use in acute exacerbations of chronic airflow obstruction in the ED, 113 patients with an average age of 66 years, acute or chronic dyspnea, an FEV1 of <60% and FEV1/FVC ratio of <60% were included in a randomized, double-blinded, interventional clinical trial. All patients received the same bronchodilator treatment. At 6 hours the steroid-treated group showed a 21.71 L/min improvement in PEFR (P < .05) and 0.14 L improvement in FEV1 (P < .05), while the nonsteroid group showed insignificant improvements of 5.52 L/min and 0.02 L, respectively. Of those patients receiving steroids, 22 achieved >40% improvements in PEFR by 6 hours and 17 achieved similar results in FEV1, whereas of those not receiving steroids, 13 and 8, respectively, achieved improvements. Within 24 hours of observation in the ED, 10 patients receiving steroids were discharged and none relapsed within 2 weeks. Of those not receiving steroids, only 10 were discharged and 3 returned with exacerbations. Although early response to steroids in chronic airflow obstruction is variable, the overall medical and cost benefits justify their early use in acute exacerbations.
KW - Lung diseases, obstructive
KW - emergency service, hospital
KW - forced expiratory volume
KW - hydrocortisone (therapeutic use)
KW - peak expiratory flow rate
KW - steroids (therapeutic use)
UR - http://www.scopus.com/inward/record.url?scp=0029969573&partnerID=8YFLogxK
U2 - 10.1016/S0735-6757(96)90120-5
DO - 10.1016/S0735-6757(96)90120-5
M3 - 文章
C2 - 8924134
AN - SCOPUS:0029969573
SN - 0735-6757
VL - 14
SP - 139
EP - 143
JO - American Journal of Emergency Medicine
JF - American Journal of Emergency Medicine
IS - 2
ER -