How long does stridor at rest persist in croup after the administration of oral prednisolone?

Emergency Medicine Australasia : EMA
Robyn ParkerAnne-Maree Kelly

Abstract

To determine the duration of stridor at rest (SAR) after the administration of oral prednisolone (1 mg/kg) to children admitted to hospital with croup from the ED. The secondary objective was to determine whether children with mild croup had a more rapid resolution of SAR. This was a retrospective explicit chart review of all children admitted to the paediatric ward of a community, paediatric teaching hospital with a diagnosis of croup over one year. Data collected included patient demographics, Westley and Geelhoed croup scores on presentation to the ED and the duration of SAR after administration of steroids. For the 188 cases analyzed, median duration of SAR was 6.5 h (95% CI 6-7 h, range 0.5-82 h). Children with a Westley score of < or = 2 or a Geelhoed score of < or = 3 had a shorter duration of SAR than those with higher scores (6 h vs. 7 h, P < 0.05), which although statistically significant is unlikely to be of clinical significance. Stridor at rest resolves promptly after the administration of oral steroids in the vast majority of cases. This suggests that a subset of patients previously admitted to hospital with croup may be able to be treated and discharged from the ED.

References

May 1, 1978·American Journal of Diseases of Children·C R WestleyJ G Brooks
Dec 1, 1995·Pediatric Pulmonology·G C Geelhoed, W B Macdonald
Aug 26, 1998·The New England Journal of Medicine·D M Jaffe
Jun 24, 1999·Journal of Biopharmaceutical Statistics·S A JuliousD G Altman
Sep 3, 1999·BMJ : British Medical Journal·M AusejoT P Klassen

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Citations

Feb 14, 2006·Paediatric Respiratory Reviews·Dominic A Fitzgerald
Apr 30, 2019·Breathe·Muthukumar SakthivelColin V E Powell

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