PEDIATRICS Vol. 80 No. 2 August 1987, pp. 225-230
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Intravenous Methylprednisolone Efficacy in Status Asthmaticus of Childhood

Robert E. Younger MD1, Patricia S. Gerber MD1, Henry G. Herrod MD1, Robert M. Cohen MD1, and Lloyd V. Crawford MD1

1 From the Department of Pediatrics, Division of Cilnical Immunology, LeBonheur Children's Medical Center, University of Tennessee, Memphis

Forty-nine nonsteroid-dependent children hospitalized with status asthmaticus were randomized to receive IV placebo or methylprednisolone treatment (1 mg/kg every six hours). All patients received nebulized isoetharine inhalations and continuous IV aminophylline infusion. Twenty-four hours after admission, the methylprednisolone-treated patients demonstrated a greater rate of improvement in their clinical scoring index than did placebo-treated children. However, the duration of hospital stay was not significantly shortened. Twenty-eight of the patients performed serial bedside spirometry at 0, 12, 24, and 36 hours after admission. The methyl-prednisolone-treated patients experienced a more rapid recovery from peripheral airway obstruction as measured by forced expiratory flow rate during 25% to 75% of forced vital capacity (FEF25-75). The magnitude and rate of improvement in FEF25-75 was significantly greater at 36 hours (P < .05) and independent of changes in peak expiratory flow rate, forced vital capacity, or forced expiratory volume in the first second of forced vital capacity. Placebo-treated patients had a higher incidence of asthma relapse within 4 weeks of discharge (eight v two relapses, P < .05). Findings of this study indicate that IV corticosteroid therapy is beneficial in treating pediatric status asthmaticus.

Key Words: status asthmaticus • corticosteroid • methylprednisolone

Submitted on April 21, 1986
Accepted on August 20, 1986




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