INHALED STEROIDS IN EMERGENCY REDUCES HOSLPITALISATION..

Inhaled steroids in the accident and emergency department
The article:

Edmonds ML, Camargo CA Jr, Pollack CV Jr, Rowe BH. Early use of inhaled corticosteroids in the accident and emergency department treatment of acute asthma (Cochrane Review). In The Cochrane Library, 1, 2001. Oxford:

The problem:

Can the use of inhaled steroids help patients having asthma attacks when they have to receive treatment in the accident and emergency department?

The study:

This study was a review of clinical trials conducted by the Cochrane Airways Group. The researchers found 6 clinical trials that included 352 adults and children with acute asthma who were treated at the accident and emergency department. Of these patients, 179 were given inhaled steroids and 173 were not. Hospitalisation rates and lung function were compared in the two groups.

The result:

Adults who were not taking concomitant oral steroids had a significantly lower rate of hospitalisations when they were given an inhaled steroid in the accident and emergency department compared to those who did not receive an inhaled steroid. For those who were taking oral steroids before they had to go to the accident and emergency department, the need for hospitalisation was only slightly reduced when they were given inhaled steroids. Those who did get inhaled steroids also had a slight improvement in lung function. There were few adverse effects for either adults or children with the inhaled steroids.

The conclusion:

Inhaled steroids can reduce admissions to hospital for patients with asthma attacks who are not receiving oral steroids. For children, inhaled steroids are at least as effective as oral steroids.In adult patients who have not received systemic steroids, inhaled steroids decreases future admissions to the hospital. There is insufficient evidence that inhaled steroids alone can be used in place of systemic (oral or injected) steroids therapy. While these conclusion may also be true for children, there is insufficient information to confirm it.