Effectivness of Nebulized Budesonide for COPD Exacerbation Management in Emergency Department; a Randomized Clinical Trial
Introduction: Nebulized budesonide has been long used in chronic obstructive pulmonary disease (COPD) exacerbation. This study aimed to compare the effectiveness of nebulized budesonide (NB) versus oral prednisolone (OP) in increasing peak expiratory flow rate (PEFR) of COPD patients in emergency d...
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doaj-9019cf9c57a7478fa38caaefee9f7cd72020-11-25T03:39:27ZengShahid Beheshti University of Medical SciencesArchives of Academic Emergency Medicine2645-49042020-10-018110.22037/aaem.v8i1.943Effectivness of Nebulized Budesonide for COPD Exacerbation Management in Emergency Department; a Randomized Clinical TrialMehrad Aghili0Elnaz Vahidi1Narges Mohammadrezaei2Tina Mirrajei3Atefeh Abedini4Department of Emergency Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2- Prehospital and Hospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran.Department of Emergency Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2- Prehospital and Hospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran.Department of Emergency Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2- Prehospital and Hospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran.Department of Emergency Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences. Introduction: Nebulized budesonide has been long used in chronic obstructive pulmonary disease (COPD) exacerbation. This study aimed to compare the effectiveness of nebulized budesonide (NB) versus oral prednisolone (OP) in increasing peak expiratory flow rate (PEFR) of COPD patients in emergency department (ED). Methods: Patients with COPD exacerbation, referring to ED were enrolled in this randomized trial study. In the first group, NB 0.5 mg every 30 minutes till three doses, placebo tablet, and standard treatment was administered. In the second group, nebulized normal saline, OP tablet 50 mg, and standard treatment were administered. Patients’ demographic data, vital signs, PEFR, venous blood gas (VBG) analysis, disposition, and patient and physician satisfaction were all collected and compared between the two groups. Results: 43 patients in the NB group and 41 patients in the OP group were evaluated. The two groups had similar age (p=0.544) and gender (p=0.984) distribution, duration of illness (p=0.458), and baseline PEFR (p=0.400). 12 and 24 hours after treatment, significant increase in PEFR in the NB and OP groups were observed (p=0.032 and 0.008; respectively). The upward trend of PEFR in NB group was significantly better than that of OP group during 24 hours of treatment (p=0.005). Vital signs and VBG results showed no significant differences between the two groups during the studied time interval. Conclusion: NB, compared to OP, could more effectively increase PEFR and ameliorate disease severity of patients with COPD exacerbation at 12 and 24 hours after treatment in ED. https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/943Budesonide; Drug Administration Routes; Emergency Service, Hospital; Nebulizers and Vaporizers; Peak Expiratory Flow Rate; Prednisolone; Pulmonary Disease, Chronic Obstructive |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Mehrad Aghili Elnaz Vahidi Narges Mohammadrezaei Tina Mirrajei Atefeh Abedini |
spellingShingle |
Mehrad Aghili Elnaz Vahidi Narges Mohammadrezaei Tina Mirrajei Atefeh Abedini Effectivness of Nebulized Budesonide for COPD Exacerbation Management in Emergency Department; a Randomized Clinical Trial Archives of Academic Emergency Medicine Budesonide; Drug Administration Routes; Emergency Service, Hospital; Nebulizers and Vaporizers; Peak Expiratory Flow Rate; Prednisolone; Pulmonary Disease, Chronic Obstructive |
author_facet |
Mehrad Aghili Elnaz Vahidi Narges Mohammadrezaei Tina Mirrajei Atefeh Abedini |
author_sort |
Mehrad Aghili |
title |
Effectivness of Nebulized Budesonide for COPD Exacerbation Management in Emergency Department; a Randomized Clinical Trial |
title_short |
Effectivness of Nebulized Budesonide for COPD Exacerbation Management in Emergency Department; a Randomized Clinical Trial |
title_full |
Effectivness of Nebulized Budesonide for COPD Exacerbation Management in Emergency Department; a Randomized Clinical Trial |
title_fullStr |
Effectivness of Nebulized Budesonide for COPD Exacerbation Management in Emergency Department; a Randomized Clinical Trial |
title_full_unstemmed |
Effectivness of Nebulized Budesonide for COPD Exacerbation Management in Emergency Department; a Randomized Clinical Trial |
title_sort |
effectivness of nebulized budesonide for copd exacerbation management in emergency department; a randomized clinical trial |
publisher |
Shahid Beheshti University of Medical Sciences |
series |
Archives of Academic Emergency Medicine |
issn |
2645-4904 |
publishDate |
2020-10-01 |
description |
Introduction: Nebulized budesonide has been long used in chronic obstructive pulmonary disease (COPD) exacerbation. This study aimed to compare the effectiveness of nebulized budesonide (NB) versus oral prednisolone (OP) in increasing peak expiratory flow rate (PEFR) of COPD patients in emergency department (ED).
Methods: Patients with COPD exacerbation, referring to ED were enrolled in this randomized trial study. In the first group, NB 0.5 mg every 30 minutes till three doses, placebo tablet, and standard treatment was administered. In the second group, nebulized normal saline, OP tablet 50 mg, and standard treatment were administered. Patients’ demographic data, vital signs, PEFR, venous blood gas (VBG) analysis, disposition, and patient and physician satisfaction were all collected and compared between the two groups.
Results: 43 patients in the NB group and 41 patients in the OP group were evaluated. The two groups had similar age (p=0.544) and gender (p=0.984) distribution, duration of illness (p=0.458), and baseline PEFR (p=0.400). 12 and 24 hours after treatment, significant increase in PEFR in the NB and OP groups were observed (p=0.032 and 0.008; respectively). The upward trend of PEFR in NB group was significantly better than that of OP group during 24 hours of treatment (p=0.005). Vital signs and VBG results showed no significant differences between the two groups during the studied time interval.
Conclusion: NB, compared to OP, could more effectively increase PEFR and ameliorate disease severity of patients with COPD exacerbation at 12 and 24 hours after treatment in ED.
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topic |
Budesonide; Drug Administration Routes; Emergency Service, Hospital; Nebulizers and Vaporizers; Peak Expiratory Flow Rate; Prednisolone; Pulmonary Disease, Chronic Obstructive |
url |
https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/943 |
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