Uluca, Ünal Dicle Üniversitesi - Tıp Fakültesi - Çocuk Hastalıkları Anabilim Dalı, Türkiye , Keskin, Özlem Gaziantep Üniversitesi - Tıp Fakültesi - Çocuk Astım ve Allerji BD, Türkiye , Gögebakan, Bülent Mustafa Kemal Üniversitesi - Tıp Fakültesi - Tıbbi Biyoloji AD, Türkiye , Balaban, Sinan Şanlıurfa Kadın Hastalıkları ve Doğum Hastanesi Yenidoğan - Yoğun Bakım Ünitesi, Türkiye , Keskin, Mehmet Gaziantep Üniversitesi - Tıp Fakültesi - Çocuk Endokrinoloji BD, Türkiye , Küçükosmanoğlu, Ercan Dicle Üniversitesi - Tıp Fakültesi - Çocuk Sağlığı ve Hastalıkları AD, Türkiye

The comparison of early and late effectiveness of systemic and high dose inhaled glucocorticoids in the management of acute asthma attacks in children

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Objective: In this study it was aimed to compare effectiveness of systemic steroids and inhaled corticosteroids in children who applied with acute asthmatic attack. Materials and methods: Children with acute asthmatic attack were randomly allocated to two groups; 1 mg/kg per oral methylprednisolone was given to Group 1 (Systemic steroid group, n=27), and 4000 μg inhaled fluticasone to Group 2 (Inhaled steroid group, n=35). Following treatment patients were evaluated for four hours, at one-hour intervals by asthma score, forced expiratory volume in first-second (FEV1) and peak expiratory flow (PEF). Primary outcome of this study was the rate of hospital admissions and secondary outcome were asthma score, FEV1, PEF and oxygen saturation. Results: Significant improvements were obtained in measured parameters in both Group 1 and Group 2. Values of measured parameters at hospital admission, 4th hour of treatment and while patients were in comfort were as follow: PEF values (Group 1: 173, 223, 220 L/min, p 0.001): Group 2 113, 141 , 192 L/min, p 0.001); FEV 1 (Group 1: 74.9%, 89.5%, 85.6%, p 0.0001; Group 2: 96, 89.8, 93.2 %, p 0.0001); O2 saturation (Group 1:93.2%, 95.6%, 96.8%, p 0.0001, Group 2: 93%, 95.2%, 96.6%, p 0.001); and asthma score (Group 1: 9.4, 6.6, 5.7, p 0.001, Group 2: 9.3, 6.8, 6.5, p 0.001). In all measured parameters significant improvements were observed with treatment modalities within both groups. No significant differences were found in all parameters between Group 1 and Group 2 (p 0.05). Conclusion: No significant differences were found in asthma score, FEV 1 and PEF parameters between systemic high-dose methylprednisolone and inhaled fluticasone treatment modalities in acute asthmatic attacks of children.

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Asthma , asthma exacerbation , inhaled fluticasone , systemic corticosteroid

Dicle Medical Journal

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