Methylprednisolone vs Dexamethasone in Management of COPD Exacerbation; a Randomized Clinical Trial
Journal Title: Archives of Academic Emergency Medicine - Year 2017, Vol 5, Issue 1
Abstract
Introduction: Corticosteroids are routinely used in management of chronic obstructive pulmonary disease (COPD) exacerbation. The main purpose of present study was to compare the efficacy of methyl prednisolone (MP) and dexamethasone (DXM) for this purpose. Methods: Adult COPD patients entered the present clinical trial. All patients received standard treatment on admission and were then divided into 2 groups of intravenous MP and DXM. Patients were asked to rate their shortness of breath; sputum volume and viscosity; dyspnea; cough; and general wellbeing on a 0-5 scale. Baseline parameters such as O2 saturation, arterial blood gas parameters, and white blood cell (WBC) count were compared on admission and day 7 and 14 of therapy using SPSS 22. Results: 68 patients were randomly allocated to 2 groups of 34 (82.4% male). The baseline characteristics of the two groups were similar (p < 0.05). Comparison of treatment outcomes for the 7th day showed a significant difference between the 2 groups only regarding cough (p = 0.047), HCO3 (p < 0.001), and O2 saturation (p = 0.042). On day 14 the 2 groups were different only regarding cough (p = 0.048) and sputum viscosity (p = 0.011). There was a significant difference between the two groups regarding trend of changes in dyspnea (p = 0.02; DXM >> MP) and cough (p = 0.035; MP >> DXM). There were no significant differences between the two medications regarding side effects on 7th and 14th day after treatment. Conclusion: It seems that MP and DXM have similar efficacy and side effects in treatment of COPD exacerbation and selecting drug of choice would better be based on the most prominent symptoms of patients on admission.
20-Day Trend of Serum Potassium Changes in Bam Earthquake Victims with Crush Syndrome; a Cross-sectional Study
Introduction: Many of those who survive following an earthquake die in the next phase due to preventable and treatable medical conditions such as hyperkalemia. The present study aimed to evaluate the trend of potassium c...
A 78-Year-Old Woman with Fecaloid Vaginal Discharge
A 78-year-old woman with a history of colon cancer with metastasis to the liver was presented to our emergency department because of bilateral groin pain and difficulty in walking, which had gradually increased during th...
Saline Flush versus Chest x ray in Confirmation of Central Venous Catheter Placement; a Diagnostic Accuracy Study
Introduction: Central venous catheterization (CVC) is a commonly performed procedure in critically ill patients of emergency department. This study was designed to compare the diagnostic accuracy of saline flush with CXR...
Dissimilarity in the Frequency of Venous Thromboembolism Risk Factors among Studies, a Commentary
Venous Thromboembolism (VTE) is the 3rd most prevalent vascular disease behind myocardial infarction and cerebrovascular ischemic attack (1). This disorder has received attention from health policy makers because of its...
Epidural Hematoma Following Hemodialysis in a Methanol Poisoned Pa-tient; a Case Report
Brain injury associated with methanol toxicity can be ischemic, necrotic or hemorrhagic in nature. It most commonly affects the putamen area bilaterally; however, it can be seen in other locations. This report describes...