Article Text

PO-1015 Impact Of Glucocorticoid Therapy In Patients With Moderate Or Severe Bronchiolitis. Preliminary Results
  1. I Jordan1,
  2. M Balaguer2,
  3. A Felipe2,
  4. L Hernandez2,
  5. E Esteban1,
  6. A Murciano3,
  7. L Alsina4,
  8. M Molero5,
  9. FJ Cambra1
  1. 1PICU, Hospital Sant Joan de Déu, Barcelona, Spain
  2. 2Pediatric Intensive Care Unit, Hospital Sant Joan de Déu, Barcelona, Spain
  3. 3Farmacologist, Hospital Sant Joan de Déu, Barcelona, Spain
  4. 4Immunology, Hospital Sant Joan de Déu, Barcelona, Spain
  5. 5Laboratory, Hospital Sant Joan de Déu, Barcelona, Spain

Abstract

Objective To determine if 7 day course of systemic glucocorticoids decreases the inflammatory activity in infants with severe bronchiolitis, compared with placebo.

Method and settings Prospective, randomised, double blind and placebo controlled study. Experimental group (1): iv methylprednisolone 2 mg/kg/day and/or oral prednisolone 2,5 mg/kg/day, during 7 days. Control group (2): iv/oral glucose 5% solution as placebo. Statistical valuation needed 39 patients per group. Inclusion: patients with moderate-severe bronchiolitis, under 1 year, who require hospitalisation. Recorded variables: epidemiological and clinical data; PRISM-III punctuation and HSJD bronchiolitis severity score punctuation. Laboratory data: inflammatory (IL-12, IL-2) and anti-inflammatory Interleukins (IL-4, IL-10) and Gamma-IF; at admission and 5 days. Spss19.0® programe was used: data was expressed as median and interquartil range (p25–75). U de Mann-Whitney was indicated to quantitative data and c2 to qualitative one.

Results There were randomised 100 patients (2011–2012), 94 analysed (48 group 1, 46 group2). There were 50 males (53.2%) with a median age of 37 days (p25–75 22–57). Median PRISM was 3 points (p25–75 0–4) and median HSJD severity score 9 (p25–75 9–16). There weren’t significant differences between groups regarding sex, age, weight, or severity scores. IL response: there weren’t statistical significant differences in the IL levels at admission moment. There weren’t diferencies in gamma-IF levels between groups. There were only statistical significant differences in IL4 and IL10 at 5 days, with higher values in group 2.

Conclusion Glucocorticoid therapy in patients with moderate or severe bronchiolitis probably conduces to an early stop in the anti inflammatory response.

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