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PubMed · 10843978

COPD: early detection and intervention.

Abstract

The compelling evidence for the increasing economic and social burden of COPD, resulting from its rising prevalence and significant morbidity, has been reviewed in other sections of this supplement. The impact of this disease within the United States and globally is projected to increase irrespective of short-term medical action, but developing successful strategies to identify the illness and reduce its impact is essential if this growing problem is to be managed successfully. In this article, some of the important concepts relevant to this process are considered, and some of the present techniques used to intervene in established COPD are reviewed.

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BibTeXRIS

P M Calverley. 2000. COPD: early detection and intervention.. https://doi.org/10.1378/chest.117.5_suppl_2.365s

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A randomized comparison of dexamethasone 0.15 mg/kg versus 0.6 mg/kg for the treatment of moderate to severe croup.

BACKGROUND: Although previous studies have shown that dexamethasone is useful in croup, the optimal dosage has not been clarified yet. The aim of this study was to investigate the effectiveness of dexamethasone 0.15 mg/kg single dose compared with the recommended dose of 0.6 mg/kg for treatment of hospitalized children with moderate to severe croup. METHOD: Forty-one children aged 6 months to 5 years admitted from March 2001 to October 2003 at the pediatric ward of Hatyai Hospital with moderate to severe croup were recruited for the study. After random allocation, each child received a single intravenous injection of either dexamethasone 0.6 mg/kg (maximum dose 12 mg) or 0.15 mg/kg (maximum dose 3 mg). All children were given a single dose of epinephrine nebulization at the beginning of the study. The croup scores were measured at 0, 1, 2, 3, 4, 6, 8, 10 and 12 h after the dexamethasone injection. RESULTS: One hour following the injection, the mean croup scores were significantly reduced from baseline values in both groups (p<0.01). There was no difference in the mean croup scores between the two groups at any time. Median times to croup scores equal or less than two in both high- and low-dose groups were 8 and 7.9 h, respectively. No patient required intubation or was removed from the study because of a rising croup score after enrollment. There was no significant adverse reaction from dexamethasone treatment in either group. CONCLUSION: Dexamethasone 0.15 and 0.6 mg/kg are equally effective in the treatment of moderate to severe croup.

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