Corticosteroids do not affect the clinical or physiological status of infants with bronchiolitis

Abstract

The treatment of infants aged 1.5–11.0 months suffering from acute bronchiolitis with a combination of inhaled albuterol and systemic corticosteroids or inhaled albuterol and placebo was compared in 50 infants in a double blind study. The mean initial clinical score and the rate of improvement was similar in the two groups. The mean ± SD hospital stay was 5.0 ± 1.2 days for the steroid group and 5.2 ± 1.7 days for the placebo group. Lung function was measured in 14 infants (7 from each group) and showed evidence of increased lung volumes and severe airway obstruction in the acute stage (the mean values for the steroid group were: TGV, 31 mL/kg; SGaw, 0.104 L/s·cmH₂O; V̇_maxFRC, 12.9 mL/s/kg; for the placebo group: TGV, 35 mL/kg; SGaw, 0.104 L/s·cmH₂O; V̇_maxFRC, 8.5 mL/s/kg) which had improved 2–4 weeks later (steroid group: TGV, 25 mL/kg; SGaw, 0.168 L/s·cmH₂O; V̇_maxFRC, 21.6 mL/s/kg; –placebo group: TGV, 24 mL/kg, SGaw, 0.198 L/s·cmH₂O, V̇_maxFRC, 17.5 mL/s/kg). There were no significant differences of thoracic gas volume, specific airway conductance, and forced expiratory flow at resting lung volume between the two groups, either in the acute or convalescent stages. We conclude that corticosteroids do not change the rate of clinical improvement in acute bronchiolitis, nor do they effect lung function 2–4 weeks later. Pediatr Pulmonal 1990; 9:181–185.