Allergy and Airway |

A Pilot Study of the Use of Steroids for Acute Exacerbations of COPD FREE TO VIEW

Ali Eskandar; Feras Mahdi, MPH; Amanda Keith; Akram Khan
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Casa Grande Medical Center, Casa Grande, AZ

Chest. 2014;146(4_MeetingAbstracts):50A. doi:10.1378/chest.1994921
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SESSION TITLE: COPD Treatment Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines recommend oral steroids to be used for acute exacerbations of Chronic Obstructive Pulmonary Disease (COPD). This has endorsed by professional societies including American Thoracic Society and European Respiratory Society. We conducted a survey to check the route and dose of steroids used for non-ICU in-patients with acute exacerbations of COPD (AECOPD).

METHODS: Physicians were asked about the dose and route of steroids they order for non-ICU inpatient AECOPD, and if they practice in private or academic hospital. Questions were conducted through ACCP e-community network where discussions have been posted on 4 networks including Critical Care, Interstitial and Lung Disease, Respiratory Care, and Clinical Research.

RESULTS: The discussion topics were accessible to more than 5000 members and they were viewed by 167 members. We had a total of 26 replies including 18 from United Stated, India 1, Pakistan 1, Brazil 1, Lebanon 2, United Kingdom 1, Germany 1, and France 1. Response rate 15.6%. IV steroids were more frequently than oral steroids by 16 out of 26 responders (61.5%); twelve of these surveys were from Unites States. Oral steroids were used by 9 (34.6%), and inhaled steroids by 1 3.9%(France). 18 out 26 surveys came from physicians who practice in an academic settings and 11 out of 18 use IV steroids. Methylprednisolone 60mg every 6 hours was the most frequently used intravenous steroid (11 out of 14 surveys), followed by hydrocortisone 100-200 mg every 8 hours. Prednisone 40-60 mg daily for 5 to 10 days was the most commonly used oral steroid.

CONCLUSIONS: View and response rates for surveys in ACCP e-communities remain low. Initial pilot results show intravenous (IV) steroids continued to be used commonly for AECOPD exacerbations especially in the United States in our small sample although guidelines have not shown benefit of IV over oral steroids.

CLINICAL IMPLICATIONS: The results of this survey warrants further studies and large scale survey that is planned later during the year.

DISCLOSURE: The following authors have nothing to disclose: Ali Eskandar, Feras Mahdi, Amanda Keith, Akram Khan

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