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Severe hospitalized croup: Treatment trends and prognosis
Author(s) -
Postma Duncan S.,
Jones Raleigh O.,
Pillsbury Harold C.
Publication year - 1984
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1288/00005537-198409000-00008
Subject(s) - croup , intensive care medicine , medicine , pediatrics
We have reviewed 43 cases of severe croup admitted from 1977 to 1981 at North Carolina Memorial Hospital. All patients were treated with mist, 23 (54%) of 43 were treated with racemic epinephrine, but only 7 (16%) of 43 were treated with steroids. None of the 5 patients who required intubation received steroids. Nine (36%) of 25 patients available for at least 6 months of follow‐up had subsequent clinical diagnoses of asthma. We have concluded that: 1 . males with subglottic narrowing on x‐ray, high leukocyte counts, and no steroid treatment appear to have increased need for airway support; 2 . while humidification and racemic epinephrine are accepted forms of treatment, steroids are still rarely used even in severe croup; 3 . severe croup may be a signal for the later development of asthma. Because it is difficult to predict which patients with severe croup will need later airway management, we strongly recommend that all patients with croup requiring racemic epinephrine be treated with at least a single dose of 1.0 to 1.5 mg/kg of dexamethasone.