EFFECT OF ADDING INHALED STEROIDS IN MODERATE TO SEVERE ACUTE WHEEZING ATTACKS IN CHILDREN AGED 2-12 YEARS

Abstract

TYPE: Abstract TOPIC: Pediatrics PURPOSE: Determine effect of adding inhaled corticosteroids(ICS) in pediatric acute asthma management METHODS: Prospective observational study . Children aged 2- 12 years admitted with moderate or severe attacks of wheezing (pulmonary scoring index- 4-6 and >6 respectively) in emergency department during September 2016 to august 2017 were studied. Children received either standard treatment as per GINA guidelines alone or additional inhaled Budesonide 0.5mg Q 12h during the first 48h, as per treating pediatricians' preference.Time taken for PSI score to fall <4 and duration of hospital stay were outcome variables Statistical analysis with SPSS 16 version and comparison with chi-square test. RESULTS: 200 children (moderate - 153 and severe- 47) were studied. Children with moderate exacerbation who received budesonide (67) took slightly shorter time for improvement i.e 11.99 +/- 3.2 h vs 12.72 +/- 3.2 h (P- 0.162) and shorter duration of hospital stay i.e 4.55 +/- 0.85 days vs 5.08 +/- 1.2 days (P> 0.05). 41 children with severe attack received Budesonide and they took shorter time for improvement i.e 15.02 +/- 3.8h vs 15.33 +/- 3h (P- 0.849) and had a shorter hospital stay i.e 4.95 +/- 1.07 days vs 6.33 +/- 1.9d (P- 0.073). CONCLUSIONS: Adding ICS to standard treatment can have a marginal advantage in acute asthma management of children, in terms of time for improvement and duration of hospital stay. The effect is better in moderate exacerbations where airway obstruction is not so severe that it permits drug delivery to target sites CLINICAL IMPLICATIONS: ICS may be beneficial in Pediatric acute asthma management DISCLOSURE: Nothing to declare. KEYWORD: nebulised budesonide