PMID: 8946123Oct 1, 1996Paper

Outpatient management of croup

Current Opinion in Pediatrics
T P Klassen, P C Rowe

Abstract

Now that there is widespread acceptance of glucocorticoids for inpatient treatment of croup, the focus of research has shifted to the effectiveness of glucocorticoids for outpatients with croup. Recent evidence from randomized controlled trials has shown that nebulized budesonide causes an acute improvement in croup symptoms, shortens stay in the emergency department, and significantly reduces admission rate. Intramuscular or oral dexamethasone also result in acute clinical improvement in patients with croup, and oral dexamethasone reduces the length of stay in an emergency department observation unit. There is accumulating evidence that patients receiving epinephrine do not necessarily require hospitalization but when treated simultaneously with dexamethasone may be safely discharged to home after a 3-hour observation period. Future trials in outpatients with croup need to determine the optimal dosing of oral dexamethasone, the utility of epinephrine therapy alone or in combination with glucocorticoids, and the optimal glucocorticoid regimen (budesonide, dexamethasone, or budesonide and dexamethasone).

Citations

Jun 30, 2004·Paediatric Respiratory Reviews·Thomas Nicolai
Jul 1, 1982·AORN Journal·R L Rayburn, G Gatch
Aug 3, 1999·Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie·P Lebecque
Apr 17, 1998·Journal of Perianesthesia Nursing : Official Journal of the American Society of PeriAnesthesia Nurses·R A Marley
Jan 21, 2011·The Cochrane Database of Systematic Reviews·Kelly F RussellTerry P Klassen

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