We enrolled 44 adult patients aged 18 to 49 with acute asthma who were seen in the emergency department (ED) in a 450-bed city-county teaching hospital over a 13-month period. All patients enrolled in the study were able to give informed consent and were suffering from an acute exacerbation of asthma without other underlying serious conditions. Diagnosis of asthma was defined by the criteria of the American Thoracic Society. Further inclusion criteria were as follow: (a) failed to respond adequately to four hours of standardized treatment in the ED (albuterol, 2.5 mg nebulized every hour for four doses; methylprednisolone, 125 mg intravenously on admission to ED, and oxygen), and (b) deemed in need of hospitalization by the ED physician guided by the criteria of the American Thoracic Society. Patients with chronic bronchitis or emphysema, pregnancy, respiratory failure (defined as Pco2>45, pH<7.35 with signs of respiratory muscle fatigue), and other complicating cardiopulmonary diseases (eg, pneumonia, decompensated heart failure) were excluded. The study was approved by the University Institutional Review Board. cialis professional
Upon admission to our institutions Clinical Research Center, bedside spirometry was performed before any treatments were given. Spirometry was performed by the investigators or by trained respiratory therapists. Spirometric values obtained included forced vital capacity, forced expiratory volume in the first second, and forced midexpiratory flow rate. Each spirometric test result was expressed as a percentage of predicted using accepted standards.
Inhaled Albuterol and Oral Prednisone Therapy in Hospitalized Adult Asthmatics: Methods (1)