Nebulized budesonide combined with systemic corticosteroid vs systemic corticosteroid alone in acute severe asthma managed in the emergency department: a randomized controlled trial
Dublin Core
Title
Nebulized budesonide combined with systemic corticosteroid vs systemic corticosteroid alone in acute severe asthma managed in the emergency department: a randomized controlled trial
Subject
Acute asthma, Nebulized budesonide, Systemic steroid, Emergency department
Description
Background: The additive beneft of inhaled corticosteroid when used with systemic corticosteroid in acute asthma
is still unclear. The objective of this study was to assess the efect of high and repeated doses of inhaled budesonide
when combined with the standard treatment of adult acute asthma.
Methods: It was a prospective double-blind randomized controlled study performed in the emergency department
(ED) from May 1, 2010 to February 28, 2011 (ClinicalTrials.gov, NCT04016220). Fifty patients were included and were
randomized to receive intravenous hydrocortisone hemisuccinate in association with nebulized budesonide (n =
23, budesonide group) or normal saline (n = 27, control group). Nebulization of budesonide or saline was done in
combination with 5 mg of terbutaline every 20 min the frst hour, then at 2 h (H2), and 3 h (H3). All patients received
standard treatment. Efcacy and safety of inhaled budesonide were evaluated every 30 min for 180 min.
Results: A signifcant increase in peak expiratory fow (PEF) was observed in both treatment groups at evaluation
times. The increase in PEF persisted signifcantly compared to the previous measurement in both groups. There was
no signifcant diference in the PEF between the two groups at evaluation times. There was no signifcant diference
between the two groups in the evolution in the respiratory rate and heart rate. There was also no statistically signifcant diference between the two groups in the rate of hospitalization, the discharge criteria before the end of the
protocol.
Conclusions: Considering its limited power, our study suggests that the association of nebulized budesonide with
hydrocortisone hemisuccinate has no additional efect over the use of hydrocortisone alone in adults’ acute asthma
managed in the ED.
is still unclear. The objective of this study was to assess the efect of high and repeated doses of inhaled budesonide
when combined with the standard treatment of adult acute asthma.
Methods: It was a prospective double-blind randomized controlled study performed in the emergency department
(ED) from May 1, 2010 to February 28, 2011 (ClinicalTrials.gov, NCT04016220). Fifty patients were included and were
randomized to receive intravenous hydrocortisone hemisuccinate in association with nebulized budesonide (n =
23, budesonide group) or normal saline (n = 27, control group). Nebulization of budesonide or saline was done in
combination with 5 mg of terbutaline every 20 min the frst hour, then at 2 h (H2), and 3 h (H3). All patients received
standard treatment. Efcacy and safety of inhaled budesonide were evaluated every 30 min for 180 min.
Results: A signifcant increase in peak expiratory fow (PEF) was observed in both treatment groups at evaluation
times. The increase in PEF persisted signifcantly compared to the previous measurement in both groups. There was
no signifcant diference in the PEF between the two groups at evaluation times. There was no signifcant diference
between the two groups in the evolution in the respiratory rate and heart rate. There was also no statistically signifcant diference between the two groups in the rate of hospitalization, the discharge criteria before the end of the
protocol.
Conclusions: Considering its limited power, our study suggests that the association of nebulized budesonide with
hydrocortisone hemisuccinate has no additional efect over the use of hydrocortisone alone in adults’ acute asthma
managed in the ED.
Creator
Soudani Marghli, Chafaa Bouhamed, Amira Sghaier, Nabil Chebbi, Insaf Dlala, Samia Bettout, Achref Belkacem, Sarra Kbaier, Nahla Jerbi and Abdelouahab Bellou
Publisher
BMC Emergency Medicine
Date
(2022) 22:134
Contributor
Fajar Bagus W
Format
PDF
Language
English
Type
Text
Files
Collection
Citation
Soudani Marghli, Chafaa Bouhamed, Amira Sghaier, Nabil Chebbi, Insaf Dlala, Samia Bettout, Achref Belkacem, Sarra Kbaier, Nahla Jerbi and Abdelouahab Bellou, “Nebulized budesonide combined with systemic corticosteroid vs systemic corticosteroid alone in acute severe asthma managed in the emergency department: a randomized controlled trial,” Repository Horizon University Indonesia, accessed March 10, 2025, https://repository.horizon.ac.id/items/show/4235.