{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T05:49:37Z","timestamp":1778996977279,"version":"3.51.4"},"reference-count":35,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,3,17]],"date-time":"2023-03-17T00:00:00Z","timestamp":1679011200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Evidence for the use of dexamethasone for pediatric critical asthma is limited. We sought to compare the clinical efficacy and safety of dexamethasone versus methylprednisolone among children hospitalized in the pediatric intensive care unit (PICU) for critical asthma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective, single center, open\u2010label, two\u2010arm, parallel\u2010group, nonrandomized trial among children ages 5\u221217 years hospitalized within the PICU from April 2019 to\u00a0December 2021 for critical asthma consented to receive methylprednisolone (standard care) or dexamethasone (intervention) at a 2:1 allocation ratio, respectively. The intervention arm received intravenous dexamethasone 0.25\u2009mg\/kg\/dose (max: 15\u2009mg\/dose) every 6\u2009h for 48\u2009h and the standard care arm intravenous methylprednisolone 1\u2009mg\/kg\/dose every 6\u2009h (max dose: 60\u2009mg\/dose) for 5 days. Study endpoints were clinical efficacy (i.e., length of stay [LOS], continuous albuterol duration, and a composite of adjunctive asthma interventions) and safety (i.e., corticosteroid\u2010related adverse events).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ninety\u2010two participants were analyzed of whom 31 were allocated to the intervention arm and 61 the standard care arm. No differences in demographics, clinical characteristics, or acute\/chronic asthma severity indices were observed. Regarding efficacy and safety endpoints, no differences in hospital LOS, continuous albuterol duration, adjunctive asthma intervention rates, or corticosteroid\u2010related adverse events were noted. Compared to the intervention arm, participants in the standard care arm more frequently were prescribed corticosteroids at discharge (72% vs. 13%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Among children hospitalized for critical asthma, dexamethasone appears safe and warrants further investigation to fully assess clinical efficacy and potential advantages over commonly applied agents such as methylprednisolone.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.26386","type":"journal-article","created":{"date-parts":[[2023,3,17]],"date-time":"2023-03-17T13:35:17Z","timestamp":1679060117000},"page":"1719-1727","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Dexamethasone versus methylprednisolone for critical asthma: A single center, open\u2010label, parallel\u2010group clinical trial"],"prefix":"10.1002","volume":"58","author":[{"given":"Meghan R.","family":"Roddy","sequence":"first","affiliation":[{"name":"Departments of Pharmacy Johns Hopkins All Children's Hospital  St. Petersburg Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Austin R.","family":"Sellers","sequence":"additional","affiliation":[{"name":"Institute for Clinical and Translational Research, Johns Hopkins All Children's Hospital  St. Petersburg Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristina K.","family":"Darville","sequence":"additional","affiliation":[{"name":"Departments of Pediatric Critical Care Medicine Johns Hopkins All Children's Hospital St. Petersburg Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatriz","family":"Teppa\u2010Sanchez","sequence":"additional","affiliation":[{"name":"Departments of Pediatric Critical Care Medicine Johns Hopkins All Children's Hospital St. Petersburg Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott D.","family":"McKinley","sequence":"additional","affiliation":[{"name":"Departments of Pulmonlogy Johns Hopkins All Children's Hospital St. Petersburg Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meghan","family":"Martin","sequence":"additional","affiliation":[{"name":"Departments of Emergency Medicine Johns Hopkins All Children's Hospital St. Petersburg Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil A.","family":"Goldenberg","sequence":"additional","affiliation":[{"name":"Institute for Clinical and Translational Research, Johns Hopkins All Children's Hospital  St. Petersburg Florida USA"},{"name":"Departments of Pediatrics Johns Hopkins University School of Medicine Baltimore Maryland USA"},{"name":"Departments of Medicine Johns Hopkins University School of Medicine Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas A.","family":"Nakagawa","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Critical Care Medicine University of Florida\u2010Jacksonville Jacksonville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony A.","family":"Sochet","sequence":"additional","affiliation":[{"name":"Institute for Clinical and Translational Research, Johns Hopkins All Children's Hospital  St. Petersburg Florida USA"},{"name":"Departments of Pediatric Critical Care Medicine Johns Hopkins All Children's Hospital St. Petersburg Florida USA"},{"name":"Departments of Anesthesiology and Critical Care Medicine Johns Hopkins University School of Medicine Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,3,17]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"United States Centers for Disease Control and Prevention. 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