Analysis of the Cochrane Review: Use of Systemic Corticosteroids for Acute Exacerbations of Chronic Obstructive Pulmonary Disease. Cochrane Database Syst Rev. 2014, 9:CD001288

Detalhes bibliográficos
Autor(a) principal: Azevedo, Pedro
Data de Publicação: 2014
Outros Autores: Costa, João, Vaz-Carneiro, António
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5873
Resumo: Acute exacerbations of chronic obstructive pulmonary disease are a major cause of hospital admissions and mortality, contributing to the decline in lung function, exercise capacity and quality of life. Infections are the major cause of exacerbations and treatment includes antibiotics, bronchodilators and systemic corticosteroids as anti- inflammatory agents. This Cochrane review compared: 1. use of oral and parenteral corticosteroids with placebo use; 2. routes of administration among themselves. The results indicate that there is evidence for the use of corticosteroids in the treatment of chronic obstructive pulmonary disease exacerbations since early improvement in lung function [assessed by forced expiratory volume in one second (FEV1)] has been noted, the likelihood of treatment failure and relapse in the first month has been reduced and it shortens the hospital stay in patients who do not require intensive care regimen. However, corticosteroid therapy causes an increase in adverse effects associated with drug, namely hyperglycaemia, especially if the route of administration is parenteral. Parenteral route has not shown to be superior to oral route in treatment failure, relapse, or death. Mortality up to 30 days does not seem to be affected by the use of corticosteroids.Keywords: Adrenal Cortex Hormones; Pulmonary Disease, Chronic Obstructive /drug therapy; Pulmonary Disease, Chronic Obstructive/ complications; Randomized Controlled Trials as Topic.
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spelling Analysis of the Cochrane Review: Use of Systemic Corticosteroids for Acute Exacerbations of Chronic Obstructive Pulmonary Disease. Cochrane Database Syst Rev. 2014, 9:CD001288Análise da Revisão Cochrane: Uso de Corticoterapia Sistémica nas Exacerbações Agudas da Doença Pulmonar Obstrutiva Crónica. Cochrane Database Syst Rev. 2014,9:CD001288Acute exacerbations of chronic obstructive pulmonary disease are a major cause of hospital admissions and mortality, contributing to the decline in lung function, exercise capacity and quality of life. Infections are the major cause of exacerbations and treatment includes antibiotics, bronchodilators and systemic corticosteroids as anti- inflammatory agents. This Cochrane review compared: 1. use of oral and parenteral corticosteroids with placebo use; 2. routes of administration among themselves. The results indicate that there is evidence for the use of corticosteroids in the treatment of chronic obstructive pulmonary disease exacerbations since early improvement in lung function [assessed by forced expiratory volume in one second (FEV1)] has been noted, the likelihood of treatment failure and relapse in the first month has been reduced and it shortens the hospital stay in patients who do not require intensive care regimen. However, corticosteroid therapy causes an increase in adverse effects associated with drug, namely hyperglycaemia, especially if the route of administration is parenteral. Parenteral route has not shown to be superior to oral route in treatment failure, relapse, or death. Mortality up to 30 days does not seem to be affected by the use of corticosteroids.Keywords: Adrenal Cortex Hormones; Pulmonary Disease, Chronic Obstructive /drug therapy; Pulmonary Disease, Chronic Obstructive/ complications; Randomized Controlled Trials as Topic.As exacerbações agudas da doença pulmonar obstrutiva crónica são uma das principais causas de internamentos hospitalares e de mortalidade, contribuindo para o declínio da função pulmonar, capacidade física e qualidade de vida. As infecções são a causa principal das exacerbações e o tratamento inclui antibióticos, broncodilatadores e corticóides sistémicos como agentes anti-inflamatórios. A presente revisão da Cochrane compara: 1. o uso de corticoterapia oral e parentérica com o uso de placebo; 2. as vias de administração entre si. Os resultados indicam que existe evidência a favor do uso de corticoterapia no tratamento das exacerbações da doença pulmonar obstrutiva crónica já que melhora precocemente a função pulmonar [avaliada pelo volume expiratório forçado no primeiro segundo (FEV1)], reduz a probabilidade de falência terapêutica e de recidiva no primeiro mês, encurta a hospitalização em doente que não requerem regime de cuidados intensivos. Contudo, a corticoterapia acarreta um aumento de eventos adversos associados ao fármaco, nomeadamente hiperglicémias, sobretudo se a via de administração for parentérica. A via parentérica não mostrou ser superior à via oral na falência terapêutica, recidiva ou mortalidade. A mortalidade até aos 30 dias não parece ser afectada pelo uso de corticóides.Palavras-chave: Corticosteróides; Doença Pulmonar Obstrutiva Crónica/ tratamento; Doença Pulmonar Obstrutiva Crónica/complicações; Ensaios Clínicos Controlados Aleatórios como Assunto; Revisão Sistemática.Ordem dos Médicos2014-10-02info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5873oai:ojs.www.actamedicaportuguesa.com:article/5873Acta Médica Portuguesa; Vol. 27 No. 5 (2014): September-October; 537-540Acta Médica Portuguesa; Vol. 27 N.º 5 (2014): Setembro-Outubro; 537-5401646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5873https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5873/4086Azevedo, PedroCosta, JoãoVaz-Carneiro, Antónioinfo:eu-repo/semantics/openAccess2022-12-20T11:04:35Zoai:ojs.www.actamedicaportuguesa.com:article/5873Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:19:12.640195Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Analysis of the Cochrane Review: Use of Systemic Corticosteroids for Acute Exacerbations of Chronic Obstructive Pulmonary Disease. Cochrane Database Syst Rev. 2014, 9:CD001288
Análise da Revisão Cochrane: Uso de Corticoterapia Sistémica nas Exacerbações Agudas da Doença Pulmonar Obstrutiva Crónica. Cochrane Database Syst Rev. 2014,9:CD001288
title Analysis of the Cochrane Review: Use of Systemic Corticosteroids for Acute Exacerbations of Chronic Obstructive Pulmonary Disease. Cochrane Database Syst Rev. 2014, 9:CD001288
spellingShingle Analysis of the Cochrane Review: Use of Systemic Corticosteroids for Acute Exacerbations of Chronic Obstructive Pulmonary Disease. Cochrane Database Syst Rev. 2014, 9:CD001288
Azevedo, Pedro
title_short Analysis of the Cochrane Review: Use of Systemic Corticosteroids for Acute Exacerbations of Chronic Obstructive Pulmonary Disease. Cochrane Database Syst Rev. 2014, 9:CD001288
title_full Analysis of the Cochrane Review: Use of Systemic Corticosteroids for Acute Exacerbations of Chronic Obstructive Pulmonary Disease. Cochrane Database Syst Rev. 2014, 9:CD001288
title_fullStr Analysis of the Cochrane Review: Use of Systemic Corticosteroids for Acute Exacerbations of Chronic Obstructive Pulmonary Disease. Cochrane Database Syst Rev. 2014, 9:CD001288
title_full_unstemmed Analysis of the Cochrane Review: Use of Systemic Corticosteroids for Acute Exacerbations of Chronic Obstructive Pulmonary Disease. Cochrane Database Syst Rev. 2014, 9:CD001288
title_sort Analysis of the Cochrane Review: Use of Systemic Corticosteroids for Acute Exacerbations of Chronic Obstructive Pulmonary Disease. Cochrane Database Syst Rev. 2014, 9:CD001288
author Azevedo, Pedro
author_facet Azevedo, Pedro
Costa, João
Vaz-Carneiro, António
author_role author
author2 Costa, João
Vaz-Carneiro, António
author2_role author
author
dc.contributor.author.fl_str_mv Azevedo, Pedro
Costa, João
Vaz-Carneiro, António
description Acute exacerbations of chronic obstructive pulmonary disease are a major cause of hospital admissions and mortality, contributing to the decline in lung function, exercise capacity and quality of life. Infections are the major cause of exacerbations and treatment includes antibiotics, bronchodilators and systemic corticosteroids as anti- inflammatory agents. This Cochrane review compared: 1. use of oral and parenteral corticosteroids with placebo use; 2. routes of administration among themselves. The results indicate that there is evidence for the use of corticosteroids in the treatment of chronic obstructive pulmonary disease exacerbations since early improvement in lung function [assessed by forced expiratory volume in one second (FEV1)] has been noted, the likelihood of treatment failure and relapse in the first month has been reduced and it shortens the hospital stay in patients who do not require intensive care regimen. However, corticosteroid therapy causes an increase in adverse effects associated with drug, namely hyperglycaemia, especially if the route of administration is parenteral. Parenteral route has not shown to be superior to oral route in treatment failure, relapse, or death. Mortality up to 30 days does not seem to be affected by the use of corticosteroids.Keywords: Adrenal Cortex Hormones; Pulmonary Disease, Chronic Obstructive /drug therapy; Pulmonary Disease, Chronic Obstructive/ complications; Randomized Controlled Trials as Topic.
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dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 27 No. 5 (2014): September-October; 537-540
Acta Médica Portuguesa; Vol. 27 N.º 5 (2014): Setembro-Outubro; 537-540
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