评估小儿哮喘加重时的地塞米松剂量策略

Q2 Medicine
Irene R Kelly, Thomas Laudone, Richard Lichenstein, Kristine A Parbuoni
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引用次数: 0

摘要

研究目的本研究旨在确定在小儿哮喘加重期使用地塞米松的标准剂量与基于体重的方法相比是否存在差异。.方法:这是一项单中心回顾性研究,研究对象为2018年7月1日至2021年6月30日期间因哮喘加重而前往儿科急诊室(ED)就诊的2至17岁患者。研究对象包括至少接受过一剂地塞米松治疗且有国际疾病分类第十版(ICD-10)哮喘代码的患者。主要终点是 30 天内和 31 至 90 天内急诊室复诊率。次要终点包括住院和插管的发生率、住院时间、地塞米松剂量差异、使用的其他皮质类固醇或辅助疗法以及出院时的用药升级。此外,还对呕吐、高血糖和高血压的发生率进行了评估。分类变量采用描述性统计,主要结果采用卡普兰-梅耶生存曲线和 Cox 回归进行评估:共纳入 252 名患者,其中标准剂量组 162 人,体重组 90 人。30 天和 31 至 90 天的回访率没有差异(3.1 vs 4.4,p = 0.58;3.7 vs 7.8,p = 0.16)。与基于体重的治疗组相比,标准化治疗组的住院时间明显缩短,异丙托溴铵和镁的用量也更少。不过,基于体重组的住院率总体较低。呕吐、高血糖和高血压的发生率相似:结论:地塞米松在小儿哮喘加重期的标准化给药策略显示出良好的效果,并可提高依从性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of Dexamethasone Dosing Strategies in Pediatric Asthma Exacerbations.

Objectives: This study aimed to determine if there is a difference in health care use in pediatric asthma exacerbations with dexamethasone at a standardized dose compared with a weight-based approach.  .

Methods: This was a single-center, retrospective study of patients ages 2 to 17 years presenting to the pediatric emergency department (ED) with an asthma exacerbation between July 1, 2018, and June 30, 2021. Patients who received at least 1 dose of dexamethasone and had an International Classification of Diseases, 10th revision (ICD-10) code for asthma were included. The primary end point was the rate of return visits to the ED within 30 days and 31 to 90 days. Secondary end points included incidence of hospitalization and intubation, length of stay, dexamethasone dosing discrepancies, other corticosteroids or adjunctive therapies used, and medication escalation at discharge. The incidences of vomiting, hyperglycemia, and hypertension were also evaluated. Descriptive statistics were used for categoric variables and a Kaplan-Meier survival curve and Cox regression evaluated the primary outcome.

Results: A total of 252 patients were included, 162 in the standardized dosing group and 90 in the weight-based group. There was no difference in return visits at 30 days and 31 to 90 days (3.1 vs 4.4, p = 0.58; and 3.7 vs 7.8, p = 0.16). The standardized group had a statistically significant shorter length of stay and lower ipratropium and magnesium use compared with the weight-based group. However, hospitalization rates were lower overall in the weight-based group. The incidences of vomiting, hyperglycemia, and hypertension were similar.

Conclusions: A standardized dosing strategy for dexamethasone in pediatric asthma exacerbations showed favorable outcomes and may lead to improved adherence.

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来源期刊
Journal of Pediatric Pharmacology and Therapeutics
Journal of Pediatric Pharmacology and Therapeutics Medicine-Pediatrics, Perinatology and Child Health
CiteScore
2.40
自引率
0.00%
发文量
90
期刊介绍: The Journal of Pediatric Pharmacology and Therapeutics is the official journal of the Pediatric Pharmacy Advocacy Group. JPPT is a peer-reviewed multi disciplinary journal that is devoted to promoting the safe and effective use of medications in infants and children. To this end, the journal publishes practical information for all practitioners who provide care to pediatric patients. Each issue includes review articles, original clinical investigations, case reports, editorials, and other information relevant to pediatric medication therapy. The Journal focuses all work on issues related to the practice of pediatric pharmacology and therapeutics. The scope of content includes pharmacotherapy, extemporaneous compounding, dosing, methods of medication administration, medication error prevention, and legislative issues. The Journal will contain original research, review articles, short subjects, case reports, clinical investigations, editorials, and news from such organizations as the Pediatric Pharmacy Advocacy Group, the FDA, the American Academy of Pediatrics, the American Society of Health-System Pharmacists, and so on.
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