Steroids In The Management Of Acute Asthma Exacerbations In Children, Which Form Is More Suitable?
研究概览
地位
详细说明
This study will be performed in Assiut university Children Hospital and will include patients with asthma exacerbations presented to the emergency department for three months. All children presenting to the emergency department with mild to moderate asthma exacerbations will be assessed to decide if the child needs treatment with salbutamol. Before starting treatment the Pediatric Respiratory Assessment Measure (PRAM), vital signs, and oxygen saturation will be recorded. Peak expiratory flow rate (PEFR) will also be recorded if the patient was 6 years or older.
Children with mild to moderate asthma exacerbation will be given the first dose of salbutamol and will be reassessed after 20 min by the emergency department attending. If further salbutamol is needed, subjects automatically will receive the second dose 20 min apart and receive either single dose of intramuscular dexamethasone (0.6 mg/kg to a maximum of 18 mg) or oral prednisolone for 3 days (1 mg/kg to a maximum of 40 mg), given orally .
A repeat physical examination will be performed, including oxygen saturation, vital signs, PRAM, PEFR after the 3rd dose of salbutamol and at the end of the third day to evaluate the effect of prednisolone and dexamethasone on the improvement of asthma scores. Patient compliance to prednisolone therapy for three days will be also recorded.
This study will be performed in Pediatric hospital - Assiut university and will include patients with asthma exacerbations presented to the emergency department for three months.
研究类型
注册 (实际的)
阶段
- 阶段2
联系人和位置
学习地点
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Assiut、埃及、71511
- Assiut University
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
- Ages 2 to 16 years
- Background history of asthma
- Presentation with an asthma exacerbation requiring repeated salbutamol after 20 minutes.
Exclusion Criteria:
- Less than 2 years old or over 16 years
- Critical or life-threatening asthma
- Known tuberculosis exposure
- Active varicella or herpes simplex infection
- Documented concurrent infection with Respiratory syncytial virus
- Fever >39.5°C
- Use of oral corticosteroids in the previous four weeks
- Concurrent stridor
- Significant co-morbid disease: lung, cardiac, immune, liver, endocrine, neurological or psychiatric
学习计划
研究是如何设计的？
设计细节
- 主要用途：治疗
- 分配：随机化
- 介入模型：并行分配
- 屏蔽：无（打开标签）
武器和干预
参与者组/臂 |
干预/治疗 |
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实验性的：dexamethasone
Dexamethasone is a long-acting glucocorticoid with a half-life of 36 to 72 hours .
It has been used safely in children with croup and bacterial meningitis .
It is well absorbed both orally and parenterally .Single dose of intramuscular dexamethasone (0.6 mg/kg to a maximum of 18 mg).
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Effect single dose of intramuscular dexamethasone (0.6 mg/kg to a maximum of 18 mg) in the treatment of mild to moderate acute asthma exacerbations in children
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实验性的：prednisolone
Prednisolone is relatively short acting with a half-life of 12 to 36 hours, thereby requiring daily dosing.
Outpatient steroid therapy is effective once compliance is assured.. Prolonged treatment course, vomiting, and a bitter taste may reduce patient compliance with prednisolone.
Oral prednisolone for 3 days (1 mg/kg to a maximum of 40 mg), given orally in two devided doses .
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Effect of prednisolone for 3 days (1 mg/kg to a maximum of 40 mg), given orally in two devided doses in the treatment of mild to moderate acute asthma exacerbations in children.
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研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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The Pediatric Respiratory Assessment Measure (PRAM)
大体时间：PRAM score is assessed at the end of the third day to evaluate the effect of prednisolone and dexamethasone on the improvement of asthma scores.
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The Pediatric Respiratory Assessment Measure (PRAM) , a validated, responsive and reliable tool to determine asthma severity in children aged 2 to 16 years, appears to be the most appropriate as an application in the emergency care setting . The PRAM score consists of five components and has a maximum total of 12 points: suprasternal retractions (0 to 2), scalene muscle contraction (0 to 2), air entry (0 to 3), wheezing (0 to 3) and O2 saturation (0 to 2) . |
PRAM score is assessed at the end of the third day to evaluate the effect of prednisolone and dexamethasone on the improvement of asthma scores.
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合作者和调查者
调查人员
- 学习椅：Moustafa M. El-Saied, Ph.D.of pediatrics、Assiut University -Faculty of medecin( Pediaric department)
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (预期的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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