Evidence
Alert

London’s Low Emission Zone has not been shown to improve children’s respiratory health

The Low Emission Zone covering much of Greater London was introduced between 2008 and 2012 to improve air quality. Some measures of air pollution have slightly reduced over that time, but measures of children’s respiratory health and lung development have not significantly improved. This NIHR funded study assessed over 2,000 primary school children during the ...

Alert

Reviewing inhaler technique for older people with COPD can improve disease control

Educating older adults with chronic obstructive pulmonary disease or asthma about the correct way to use their inhalers, as part of disease management, can reduce their risk of exacerbations. Either a demonstration using a placebo inhaler or written information appears effective for this. This review pooled the results of four trials, with a total of ...

Alert

Adding low dose theophylline to inhaled corticosteroids does not reduce COPD exacerbations

Taking low-dose theophylline tablets in addition to inhaled corticosteroids did not significantly reduce chronic obstructive pulmonary disease flare-ups (exacerbations). This NIHR funded study found that people taking the combination and those taking an inhaled steroid had the same number of exacerbations - just over two per year. People who experience frequent exacerbations are often prescribed ...

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People with COPD exacerbations prefer early discharge then treatment at home

People with flare-ups of COPD (chronic obstructive pulmonary disease) prefer to be managed at home rather than in hospital. Hospital stay was on average four days shorter when people were discharged early to the hospital at home scheme, and there was no noticeable increase in readmissions in this group. This NIHR-funded trial aimed to establish ...

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Steroids rapidly reduce children’s croup symptoms and shorten hospital stays

Corticosteroids reduce symptoms of croup in children within two hours and continue to do so for at least 24 hours. They also cut the amount of time children spend in hospital by 15 hours and reduce return visits or readmissions from about 20% to 10%. This Cochrane review assessed the effectiveness of corticosteroids such as ...

Collection

Nine ways research could save the NHS money

Nine ways research could save the NHS money In this highlight, we have carefully selected nine NIHR Signals that show how research could help to save the NHS money. This collection covers a range of treatments and initiatives that are cost effective for the NHS. You can find out more about Signals or read the latest on the Discover Portal. ...

Alert

High-flow oxygen therapy may have a role in treating infants with more severe bronchiolitis

A randomised controlled trial of 1,472 infants with bronchiolitis found that more children improved when started on high-flow oxygen therapy than with standard oxygen therapy. Those who failed to improve on standard therapy were switched to high flow oxygen. Most then improved - overall, similar numbers were transferred to intensive care. There was also no ...

Alert

Increasing inhaled steroids for short periods reduces asthma exacerbations

Taking four times the usual dose of inhaled corticosteroids for up to two weeks can modestly reduce the chance of asthma worsening. This NIHR-funded trial assessed increasing the inhaled corticosteroid dose compared with staying on the usual dose, as part of a self-management plan. Participants were adults and adolescents with uncontrolled asthma and had at ...

Alert

One week of steroids may be as effective as two weeks in managing severe COPD

A shorter course of steroids lasting 3 to 7 days appears as effective as the recommended 7 to 14-day standard treatment for managing a flare-up of severe chronic obstructive pulmonary disease. This update to an earlier Cochrane review looked at randomised clinical trials comparing a short course (7 days or fewer) with a longer course ...

Alert

Balanced electrolyte solutions give marginal benefit over saline for very ill patients

About 14% of critically ill patients receiving electrolyte-balanced crystalloids either developed kidney failure, needed kidney-replacement therapy or died compared with 15% receiving normal saline. This small but statistically significant benefit was only apparent when combining outcomes; there was no difference between fluids for the three individual outcomes analysed separately. A solution of 0.9% sodium chloride ...

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