What is the maximum dose and frequency for the management of pediatric respiratory crises with corticosteroids: budesonide micronebulizations / systemic corticosteroids IV or oral?

According to the District Health Secretariat, since May 2025, the city of Bogotá has experienced a significant increase in respiratory disease cases, which has placed considerable pressure on hospital capacity, especially in pediatric and intensive care services. As of June 19, 2025, hospital bed occupancy in Bogotá reached 81.8% in neonatal ICU (224 beds occupied), 92.5% in pediatric hospitalization (1,403 beds), and 96.9% in pediatric ICU (254 beds). In this context, the timely and appropriate management of in-hospital respiratory crises becomes particularly relevant, especially in critically ill pediatric patients, in order to prevent progression to respiratory failure. The following section reviews the role of corticosteroids in the management of these crises in the pediatric population.