Problemi correnti
Salbutamolo e cortisonici nell’accesso acuto d’asma
BRONCHODILATORS AND STEROIDS IN ACUTE ASTHMA: IS IT ALL CLEAR?
EGIDIO BARBI, PATRICIA PETAROS, ALESSANDRO LENHARDT, GIORGIO LONGO
Clinica Pediatrica, IRCCS “Burlo Garofolo”, Trieste
Ottobre 2004 - pagg. 559 -565
Abstract
There is wide international consensus around the treatment of acute asthma attack in children
and the relevant guidelines are well known by paediatricians. However, there are still a few
controversial aspects and aspects where it frequently occurs that practice differs from what is
recommended in the guidelines. These include the use of oral steroids in wheezing bronchitis,
the use of inhaled steroids in the acute asthma attacks, the use of intravenous salbutamol
and the best inhaling system of salbutamol. The Authors provide their views based on an extensive
literature review and their own large personal experience.
Parole chiave
Suggerite dall'AI
Classificazione MeSH
Bibliografia
1. Kelly AM, Powell C, Kerr D. Patients with a
longer duration of symptoms of acute asthma
are more likely to require admission to hospital.
Emerg Med (Fremantle) 2002;14(2):142-
5.
2. Global Iniziative for asthma. Global strategy for asthma management and prevention (GINA). National Heart, Lung and Blood Institute/ WHO Workshop Report 2002. (www.ginasthma. com).
3. Panicker J, Sethi GR, Seghal V. Comparative efficiency of commercial and improvised spacer device in acute bronchial asthma. Indian Pediat 2001;38(4):340-8.
4. Duarte M, Camargos P. Efficacy and safety of a home made non valved spacer for bronchodilator therapy in acute asthma. Acta Pediatr 2002;91(9):909-13.
5. Zar HJ, Brown G, Donson H, Brathwaite N, Mann MD, Weinberg EG. Home-made spacers for bronchodilator therapy in children with acute asthma: a randomised trial. Lancet 1999;354:979.
6. Cates CJ, Rowe BH, Bara A. Holding chambers versus nebuliseres for beta-agonist treatment of acute asthma. Cochrane database Syst Rev. 2003(3): CD000052.
7. Castro-Rodriguez JA, Rodrigo G. Beta-agonist through metered-dose inhaler with valved holding chamber versus nebulizer for acute exacerbation of wheezing or asthma in children under 5 years of age: a systematic review with meta-analysis. J Pediatr 2004;145:172-7.
8. Loffert DT, Ikle D, Nelson HS. A comparison of commercial jet nebulizers. Chest 1994;106 (6):1788-92.
9. Wildhaber JH, Nigel DD, Wilson JM, Devadasn SG, Le Souef PN. Inhalation therapy in asthma: nebulizer or pressured metered-dose inhaler with holding chamber? In vivo comparison of lung deposition in children. J Pediatr 1999;135(1):28-33.
10. Delgado A, Chou KJ, Silver EJ, Crain EF. Nebulizers vs metered-dose inhalers with spacers for bronchodilator therapy to treat wheezing in children aged 2 to 24 months in a pediatric emergency department. Arch Pediatr Adolesc Med 2003;157(1):76-80.
11. Chou KJ, Cunningham SJ, Crain EF. Metered- dose inhalers with spacers vs nebulizers for pediatric asthma. Arch Pediatr Adolesc Med 1995;149(2):201-5.
12. Closa RM, Ceballos JM, Gomez-Papi A, Galiana AS, Gutierrez C, Marti-Henneber C. Efficacy of bronchodilators administered by nebulizers versus spacer devices in infants with acute wheezing. Pediatr Pulmonol 1998; 26(5):344-8.
13. Leversha AM, Campanella SG, Aickin RP, Asher MI. Costs and effectiveness of spacer versus nebulizer in young children with moderate and severe acute asthma. J Pediatr 2000;136(4):497-502.
14. Browne GJ, Penna AS, Phung X, Soo M. Randomised trial of intravenous salbutamol in early management of acute severe asthma in children. Lancet 1997;349: 301-5.
15. Travers A, Jones AP, Kelly K, et al. Intravenous beta2-agonists for acute asthma in the emergency department. Cochrane Database Syst Rev 2001(2):CD002988.
16. Tal A, Golan H, Grauer N, Aviram M, Albin D, Quastel MR. Deposition pattern of radio labelled salbutamol inhaled from metered-dose inhaler by means of spacer with mask in young children with airway obstruction. J Pediatr 1996;128:479-84.
17. Everard ML, Clark AR, Milner AD. Drug delivery from holding chambers with attached face mask. Arch Dis Child 1992;67:580-5.
18. Amirav I, Newhouse MT. Aerosol therapy with valved holding chambers in young children: the importance of the facemask seal. Pediatrics 2001;108(2):389-94.
19. Robertson CF, Smith F, Beck R, Levison H. Response to frequent low doses of nebulized salbutamol in acute asthma. J Pediatr 1985;106(4):672-4.
20. Nelson HS. Beta-adrenergic bronchodilators. NEJM 1995;333(8):499-507.
21. Kerem E, Levison H, Schuh S, et al. Efficacy of albuterol administered by nebuliser versus spacer device in childhood with acute asthma. J Pediatr 1993; 123:313-7.
22. Smith M, Iqbal S, Elliot TM, Everard M, Rowe BH. Corticosteroids for hospitalised children with acute asthma. Cochrane Database Syst Rev 2003(2):CD002886.
23. Rowe BH, Spooner C, Ducharme FM, Bretzlaff JA, Bota GW. Early emergency department treatment of acute asthma with systemic corticosteroids. Cochrane Database Syst Rev 2001(1):CD002178.
24. Scarfone RJ, Fuchs S, Nager A, et al. Controlled trial of oral prednisone in the emergency department treatment of children with acute asthma. Pediatrics 1993;92:513-8.
25. Langton Hewer S, Hobbs J, Reid F. Prednisolone in acute childhood asthma: clinical responses to three dosages. Respir Med 1998; 92:541-6.
26. Becker JM, Arora A, Scarfone RJ, et al. Oral versus intravenous corticosteroids in children hospitalised with asthma. J Allergy Clin Immunol 1999;103:586-90.
27. Greos LS, Vichyanond P, Bloedow DC, et al. Methylprednisolone achieves greater concentrations in the lung than prednisolone. Am Rev Respir Dis 1991;144:586-92.
28. Szefler SJ. Glucocorticoid theraphy for asthma: Clinical pharmacology. J Allergy Clin Immunol 1991;88:147-65.
29. Oommen A, Lambert PC, Grigg J. Efficacy of a short course of parent-initiated oral prednisolone for viral wheeze in children aged 1-5 years: randomised controlled trial. Lancet 2003;362:1433-8.
30. Csonka P, Kaila M, Laippala P, Iso-Mustaajarvi M, Vesikari T, Ashorn P. Oral prednisolone in the acute management of children age 6 to 35 months with viral respiratory infection- induced lower airway disease; a randomised, placebo-controlled trial. J Pediatr 2003;143:725-30.
31. Weinberger M. Treatment strategies for viral respiratory infection-induced asthma. J Pediatr 2003;142:34-8.
32. Gern JE. Mechanisms of virus-induced asthma. J Pediatr 2003 Feb; 142 (2 Suppl):S9- 13; discussion S 13-4.
33. Grant CC, Duggan AK, DeAngelis C. Independent parental administration of prednisone in acute asthma: a double-blind, placebocontrolled, crossover study. Pediatrics 1995;96(2 Pt 1):224-9.
34. Horowitz L, Zafrir O, Gilboa S, Berger I, Wolach B. Acute asthma. Single dose oral steroids in paediatric community clinics. Eur J Pediatr. 1994;153(7):526-30.
35. Harris JB. Early intervention with short courses of prednisone to prevent progression of asthma in ambulatory patients incompletely responsive to bronchodilators. J Pediatr 1987; 110:627-33.
36. British Thoracic Society. Scottish intercollegiate guidelines on the management of asthma. Thorax 2003:58(suppl 1).
37. Rees PJ. New guidelines on management of asthma. BMJ 2003;360:1265.
38. Warner JO, Naspitz CK. Third International Pediatric Consensus statement on the management of childhood asthma. International Pediatric Asthma Consensus Group. Pediatr Pulmonol 1998;25(1);1-17.
39. Matthews EE, Curtis PD, McLain BI, Morris LS, Turbitt ML. Nebulised budesonide versus oral steroid in severe exacerbations of childhood asthma. Acta Paediatr 1999; 88:841-3.
40. Edmonds ML, Camargo CA, Pollack CV, Rowe BH. Early use of inhaled corticosteroids in the emergency department treatment of acute asthma. Cochrane Database Syst Rev 2003(3):CD002308.
41. Schuh S, Reisman J, Alsheri M, Dupuis A, Corey M, Arseneault R, Alothman G, Tenis O, Canny G. A comparison of inhaled fluticasone and oral prednisone for children with severe acute asthma. NEJM 2000;343(10):689-94.
42. McKean M, Ducharme F. Inhaled steroids for episodic viral wheeze of childhood. Cochrane Database Syst Rev 2000(2):CD001107.
43. Svedmyr J, Nyberg E, Thunqvist P, Asbrink-Nilsson E, Hedlin G. Prophylactic intermittent treatment with inhaled corticosteroids of asthma exacerbations due to airway infections in toddlers. Acta Pediatr 1999; 88(1):42-7.
44. Wilson NM, Silverman M. Treatment of acute, episodic asthma in preschool children using intermittent high dose inhaled steroids at home. Arch Dis Child 1990:65(4):407-10.
45. Pedersen S, O’Byrne P. A comparison of the efficacy and safety of inhaled corticosteroids in asthma. Allergy 1997;52(39 Suppl):1- 34.
46. Lipworth BJ. Treatment of acute asthma. Lancet 1997;350 Suppl 2:SII18-23.
2. Global Iniziative for asthma. Global strategy for asthma management and prevention (GINA). National Heart, Lung and Blood Institute/ WHO Workshop Report 2002. (www.ginasthma. com).
3. Panicker J, Sethi GR, Seghal V. Comparative efficiency of commercial and improvised spacer device in acute bronchial asthma. Indian Pediat 2001;38(4):340-8.
4. Duarte M, Camargos P. Efficacy and safety of a home made non valved spacer for bronchodilator therapy in acute asthma. Acta Pediatr 2002;91(9):909-13.
5. Zar HJ, Brown G, Donson H, Brathwaite N, Mann MD, Weinberg EG. Home-made spacers for bronchodilator therapy in children with acute asthma: a randomised trial. Lancet 1999;354:979.
6. Cates CJ, Rowe BH, Bara A. Holding chambers versus nebuliseres for beta-agonist treatment of acute asthma. Cochrane database Syst Rev. 2003(3): CD000052.
7. Castro-Rodriguez JA, Rodrigo G. Beta-agonist through metered-dose inhaler with valved holding chamber versus nebulizer for acute exacerbation of wheezing or asthma in children under 5 years of age: a systematic review with meta-analysis. J Pediatr 2004;145:172-7.
8. Loffert DT, Ikle D, Nelson HS. A comparison of commercial jet nebulizers. Chest 1994;106 (6):1788-92.
9. Wildhaber JH, Nigel DD, Wilson JM, Devadasn SG, Le Souef PN. Inhalation therapy in asthma: nebulizer or pressured metered-dose inhaler with holding chamber? In vivo comparison of lung deposition in children. J Pediatr 1999;135(1):28-33.
10. Delgado A, Chou KJ, Silver EJ, Crain EF. Nebulizers vs metered-dose inhalers with spacers for bronchodilator therapy to treat wheezing in children aged 2 to 24 months in a pediatric emergency department. Arch Pediatr Adolesc Med 2003;157(1):76-80.
11. Chou KJ, Cunningham SJ, Crain EF. Metered- dose inhalers with spacers vs nebulizers for pediatric asthma. Arch Pediatr Adolesc Med 1995;149(2):201-5.
12. Closa RM, Ceballos JM, Gomez-Papi A, Galiana AS, Gutierrez C, Marti-Henneber C. Efficacy of bronchodilators administered by nebulizers versus spacer devices in infants with acute wheezing. Pediatr Pulmonol 1998; 26(5):344-8.
13. Leversha AM, Campanella SG, Aickin RP, Asher MI. Costs and effectiveness of spacer versus nebulizer in young children with moderate and severe acute asthma. J Pediatr 2000;136(4):497-502.
14. Browne GJ, Penna AS, Phung X, Soo M. Randomised trial of intravenous salbutamol in early management of acute severe asthma in children. Lancet 1997;349: 301-5.
15. Travers A, Jones AP, Kelly K, et al. Intravenous beta2-agonists for acute asthma in the emergency department. Cochrane Database Syst Rev 2001(2):CD002988.
16. Tal A, Golan H, Grauer N, Aviram M, Albin D, Quastel MR. Deposition pattern of radio labelled salbutamol inhaled from metered-dose inhaler by means of spacer with mask in young children with airway obstruction. J Pediatr 1996;128:479-84.
17. Everard ML, Clark AR, Milner AD. Drug delivery from holding chambers with attached face mask. Arch Dis Child 1992;67:580-5.
18. Amirav I, Newhouse MT. Aerosol therapy with valved holding chambers in young children: the importance of the facemask seal. Pediatrics 2001;108(2):389-94.
19. Robertson CF, Smith F, Beck R, Levison H. Response to frequent low doses of nebulized salbutamol in acute asthma. J Pediatr 1985;106(4):672-4.
20. Nelson HS. Beta-adrenergic bronchodilators. NEJM 1995;333(8):499-507.
21. Kerem E, Levison H, Schuh S, et al. Efficacy of albuterol administered by nebuliser versus spacer device in childhood with acute asthma. J Pediatr 1993; 123:313-7.
22. Smith M, Iqbal S, Elliot TM, Everard M, Rowe BH. Corticosteroids for hospitalised children with acute asthma. Cochrane Database Syst Rev 2003(2):CD002886.
23. Rowe BH, Spooner C, Ducharme FM, Bretzlaff JA, Bota GW. Early emergency department treatment of acute asthma with systemic corticosteroids. Cochrane Database Syst Rev 2001(1):CD002178.
24. Scarfone RJ, Fuchs S, Nager A, et al. Controlled trial of oral prednisone in the emergency department treatment of children with acute asthma. Pediatrics 1993;92:513-8.
25. Langton Hewer S, Hobbs J, Reid F. Prednisolone in acute childhood asthma: clinical responses to three dosages. Respir Med 1998; 92:541-6.
26. Becker JM, Arora A, Scarfone RJ, et al. Oral versus intravenous corticosteroids in children hospitalised with asthma. J Allergy Clin Immunol 1999;103:586-90.
27. Greos LS, Vichyanond P, Bloedow DC, et al. Methylprednisolone achieves greater concentrations in the lung than prednisolone. Am Rev Respir Dis 1991;144:586-92.
28. Szefler SJ. Glucocorticoid theraphy for asthma: Clinical pharmacology. J Allergy Clin Immunol 1991;88:147-65.
29. Oommen A, Lambert PC, Grigg J. Efficacy of a short course of parent-initiated oral prednisolone for viral wheeze in children aged 1-5 years: randomised controlled trial. Lancet 2003;362:1433-8.
30. Csonka P, Kaila M, Laippala P, Iso-Mustaajarvi M, Vesikari T, Ashorn P. Oral prednisolone in the acute management of children age 6 to 35 months with viral respiratory infection- induced lower airway disease; a randomised, placebo-controlled trial. J Pediatr 2003;143:725-30.
31. Weinberger M. Treatment strategies for viral respiratory infection-induced asthma. J Pediatr 2003;142:34-8.
32. Gern JE. Mechanisms of virus-induced asthma. J Pediatr 2003 Feb; 142 (2 Suppl):S9- 13; discussion S 13-4.
33. Grant CC, Duggan AK, DeAngelis C. Independent parental administration of prednisone in acute asthma: a double-blind, placebocontrolled, crossover study. Pediatrics 1995;96(2 Pt 1):224-9.
34. Horowitz L, Zafrir O, Gilboa S, Berger I, Wolach B. Acute asthma. Single dose oral steroids in paediatric community clinics. Eur J Pediatr. 1994;153(7):526-30.
35. Harris JB. Early intervention with short courses of prednisone to prevent progression of asthma in ambulatory patients incompletely responsive to bronchodilators. J Pediatr 1987; 110:627-33.
36. British Thoracic Society. Scottish intercollegiate guidelines on the management of asthma. Thorax 2003:58(suppl 1).
37. Rees PJ. New guidelines on management of asthma. BMJ 2003;360:1265.
38. Warner JO, Naspitz CK. Third International Pediatric Consensus statement on the management of childhood asthma. International Pediatric Asthma Consensus Group. Pediatr Pulmonol 1998;25(1);1-17.
39. Matthews EE, Curtis PD, McLain BI, Morris LS, Turbitt ML. Nebulised budesonide versus oral steroid in severe exacerbations of childhood asthma. Acta Paediatr 1999; 88:841-3.
40. Edmonds ML, Camargo CA, Pollack CV, Rowe BH. Early use of inhaled corticosteroids in the emergency department treatment of acute asthma. Cochrane Database Syst Rev 2003(3):CD002308.
41. Schuh S, Reisman J, Alsheri M, Dupuis A, Corey M, Arseneault R, Alothman G, Tenis O, Canny G. A comparison of inhaled fluticasone and oral prednisone for children with severe acute asthma. NEJM 2000;343(10):689-94.
42. McKean M, Ducharme F. Inhaled steroids for episodic viral wheeze of childhood. Cochrane Database Syst Rev 2000(2):CD001107.
43. Svedmyr J, Nyberg E, Thunqvist P, Asbrink-Nilsson E, Hedlin G. Prophylactic intermittent treatment with inhaled corticosteroids of asthma exacerbations due to airway infections in toddlers. Acta Pediatr 1999; 88(1):42-7.
44. Wilson NM, Silverman M. Treatment of acute, episodic asthma in preschool children using intermittent high dose inhaled steroids at home. Arch Dis Child 1990:65(4):407-10.
45. Pedersen S, O’Byrne P. A comparison of the efficacy and safety of inhaled corticosteroids in asthma. Allergy 1997;52(39 Suppl):1- 34.
46. Lipworth BJ. Treatment of acute asthma. Lancet 1997;350 Suppl 2:SII18-23.