Effective control of a severe exacerbation of bronchial asthma

Aim. To evaluate effectiveness and safety of nebulizer therapy (NT) with broncholytics and pulmicort suspension (PS) in patients with a severe exacerbation of bronchial asthma (BA). Material and methods. 75 patients with a severe BA exacerbation received broncholytic NT with consideration of comorbid pathology and age. Nebulized PS was used as an alternative to systemic glucocorticosteroids (SGCS). NT efficacy was assessed by changes in clinical symptoms, in the peak expiration velocity (PEP) and spirometry parameters. Safety was controlled by 24-h ECG monitoring, pulsoximetty. PS was examined for effect on adrenal cortex, calcium metabolism, oral infection with Candida. Side effects were registered. Results. Clinical improvement was recorded in all the patients. NT reduced the number of additional inhalations of short-acting beta2-agonists 4-5 times, on the average. In the end of NT there was a 4.66% increase in SaO(2) vs the initial value (p = 0.04). PEV and FEV1 increased. Plasm levels of hydrocortisone and its urine excretion did not lower vs initial values. Conclusion. The results of the study point to efficacy and safety of combined NT with broncholytics and PS in a severe exacerbation of BA.