• Emerg Med J · Jan 2025

    Randomized Controlled Trial

    Nebulised high-dose corticosteroids as add-on therapy for adults with asthma exacerbation: a randomised controlled trial.

    • Kumpol Kornthatchapong, Nat Chatchairatanavej, Nattaya Chormai, Winchana Srivilaithon, Chitlada Limjindaporn, Narongkorn Saiphoklang, and Jiraporn Sri-On.
    • Department of Emergency Medicine, Faculty of Medicine, Thammasat University, Khlong Luang, Pathumthani, Thailand kump29@gmail.com.
    • Emerg Med J. 2025 Jan 21; 42 (2): 919791-97.

    BackgroundEvidence regarding high-dose inhaled corticosteroids (HDICS) in asthma exacerbations in adults is insufficient. This study compares the treatment outcomes of HDICS as add-on therapy to the outcomes of standard treatment in adult patients with acute asthma exacerbation in the ED.MethodsThis was a single-centre, triple-blind, randomised controlled trial conducted in the ED in Thailand between March 2022 and April 2023. Adult patients with asthma exacerbation were randomly assigned to receive either a placebo (normal saline) or HDICS (budesonide 9000 µg) nebulisation combined with beta agonist and ipratropium within the first hour. The primary endpoints were length of ED stay, hospital admission and ED revisit. The secondary endpoints were dyspnoea scale, pulmonary functions, length of hospital stay and home exacerbation after ED discharge.ResultsA total of 88 patients were randomly assigned to one of two groups: 44 patients received a HDICS and 44 patients were placed in the control group. The HDICS group had a significantly shorter ED length of stay (adjusted mean difference -133.6 min; 95% CI -242.4 to -24.8 min; p=0.016), and a higher proportion of ED discharged home within 8 and 16 hours compared with the control group. However, there were no significant differences between the two groups in hospital admission rates, ED revisit, dyspnoea scale, pulmonary functions, length of hospital stay or home exacerbation after ED discharge.ConclusionsHDICS may be useful as an add-on therapy to standard treatment for asthma exacerbation in adults to reduce ED stay.Trial Registration NumberTCTR20201214001.© Author(s) (or their employer(s)) 2025. No commercial re-use. See rights and permissions. Published by BMJ Group.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…

What will the 'Medical Journal of You' look like?

Start your free 21 day trial now.

We guarantee your privacy. Your email address will not be shared.