Dexamethasone in salbutamol-treated inpatients with acute bronchiolitis: A randomized, controlled trial☆,☆☆,★,★★
Section snippets
Study setting
The study was conducted at the Children's Hospital of Eastern Ontario, the only pediatric tertiary hospital for the Ottawa-Carleton region, with a catchment area of 1 million people. This hospital has 6800 admissions per year and 160 inpatient beds.
Selection of patients
Patients who had, for the first time, a short-term (fewer than 7 days) episode of wheezing and had evidence of a viral infection (rhinorrhea or temperature >37.5° C), and who were admitted to the inpatient wards, were eligible if they met the
Patient characteristics
The study was conducted from Feb. 1, 1993, to April 30, 1995; however, patients were enrolled only from Nov. 1 to April 30 during the peak RSV season. It was terminated after the enrollment of 72 patients because funding for the project had lapsed and we had enrolled 97% of our specified sample size. Of the 102 patients approached for the study, 30 patients did not participate because of parental refusal to give consent (n = 18), a communication barrier (n = 6), and an absent parent or guardian
DISCUSSION
This study demonstrates that oral dexamethasone is not effective as adjunctive therapy to nebulized salbutamol for children hospitalized with mild to moderate bronchiolitis. There was no significant difference between the RDAI scores of patients who received a placebo and those who received dexamethasone. The validity and responsiveness (sensitivity to change) of this clinical score has been demonstrated in other studies. 4, 14 The two groups did not differ significantly with respect to
Acknowledgements
We thank Joanne Momy, Sue Bedard, and Pat Harman for their excellent and dedicated work as research assistants, Colline Blanchard for randomization and preparation of study medication, John Lewis for his help with data entry, and the house staff, attending physicians, and nurses on the inpatient wards at the Children's Hospital of Eastern Ontario.
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2014, Paediatric Respiratory ReviewsCitation Excerpt :AS Asthma score; [13] ASS asthma severity score; [14–19] BS bronchiolitis score (original names: BS-2 respiratory scale; BS-3 clinical scoring; BS-4 severity score); [20–23] CAES clinical asthma evaluation score (original names: CAES-2 clinical severity score or modified clinical asthma score; CAES-3 modified clinical asthma score); [24–27] CAS clinical asthma score [28]; CS clinical score [29]; CSGS clinical symptom grading system; [30,31] CSS clinical scoring system (original names: CSS-2 modified Tal's clinical score; CSS-4 clinical score); [6,32–41] EDRAR escala de diffcultad respiratoria de la Argentina; [42] EDRCH escala de dificultad respiratoria de Chile;41 MPIS modified pulmonary index score; [43] PASS pediatric asthma severity score; [44,45] PRAM paediatric or preschool respiratory assessment measure; [45–47] PIS pulmonary index score; [48–54] PS pulmonary score; [45,46] RA respiratory assessment; [57] RAD respiratory rate – accessory muscle use – decreased breath sounds; [45] RDAI respiratory distress assessment instrument; [58–67] RDI respiratory distress index; [68,69] SS severity score; [70] SOIS severity of illness score [71].
Bronchiolitis
2012, Principles and Practice of Pediatric Infectious Diseases, Fourth EditionSingle oral dose of dexamethasone in outpatients with bronchiolitis: a placebo controlled trial
2009, Allergologia et Immunopathologia
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From the Departments of Pediatrics, Epidemiology, and Medicine, University of Ottawa, Ottawa, Ontario, and the Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
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Supported by grant 92-51 from Physicians Services Inc., Toronto, Ontario, Canada.
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Reprint requests: Terry P. Klassen, MD Division of Emergency Medicine, Children's Hospital of Eastern Ontario, 401 Smyth Rd., Ottawa, Ontario K1H 8L1, Canada.
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