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Viral croup: Diagnosis and a treatment algorithm
Author(s) -
Petrocheilou Argyri,
Tanou Kalliopi,
Kalampouka Efthimia,
Malakasioti Georgia,
Giannios Christos,
Kaditis Athanasios G.
Publication year - 2014
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.22993
Subject(s) - croup , medicine , heliox , dexamethasone , stridor , anesthesia , emergency department , airway , intensive care medicine , pediatrics , psychiatry
Summary Viral croup is a frequent disease in early childhood. Although it is usually self‐limited, it may occasionally become life‐threatening. Mild croup is characterized by the presence of stridor without intercostal retractions, whereas moderate‐to‐severe croup is accompanied by increased work of breathing. A single dose of orally administered dexamethasone (0.15–0.6 mg/kg) is the mainstay of treatment with addition of nebulized epinephrine only in cases of moderate‐to‐severe croup. Nebulized budesonide (2 mg) can be given alternatively to children who do not tolerate oral dexamethasone. Exposure to cold air or administration of cool mist are treatment interventions for viral croup that are not supported by published evidence, but breathing heliox can potentially reduce the work of breathing related to upper airway obstruction. In summary, corticosteroids may decrease the intensity of viral croup symptoms irrespective to their severity on presentation to the emergency department. Pediatr Pulmonol. 2014; 49:421–429. © 2013 Wiley Periodicals, Inc.