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• W156934439 abstract "Laryngotracheobronchitis (herein referred to as croup) is a common cause of upper airway obstruction in children, with as many as 6% of children in US communities experiencing this disease of sufficient severity that hospitalization is required.5 Before widespread use of glucocorticoids, as many as 31% of children required hospitalization32 and 1.7% required intubation.21 Although death per se is uncommon, health care costs resulting from hospitalization of patients with croup caused by parainfluenza has been estimated at $56 million in the United States.15 Although the debate around the effectiveness of glucocorticoids raged in the 1970s,3, 34 by the late 1980s, a consensus was building that, at least for hospitalized patients with croup, the use of glucocorticoids could hasten the improvement of clinical symptoms and reduce the probability of endotracheal intubation. This was supported by a meta-analysis by Kairys et al21 in 1989. Focus then shifted to the emergency department, in part because of increasing momentum in emergency department–based research. The question became, Would administering glucocorticoids at an earlier phase of a child's illness prevent the need for hospitalization? In addition, the development of a newer glucocorticoid, budesonide, for use in patients with asthma raised the question of whether the administration of this steroid to the upper airway of patients would result in a significant clinical improvement. This article evaluates the evidence of the effectiveness of glucocorticoids in patients with croup. Emphasis is placed on the evidence developed in the 1990s based on 15 randomized, controlled trials on the use of glucocorticoids in patients with croup. Many of these studies were conducted in emergency departments. This article also reviews the evidence regarding the use of epinephrine and mist therapy for patients with croup." @default.
• W156934439 created "2016-06-24" @default.
• W156934439 creator A5008250585 @default.
• W156934439 date "1999-12-01" @default.
• W156934439 modified "2023-10-16" @default.
• W156934439 title "CROUP" @default.
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• W156934439 doi "https://doi.org/10.1016/s0031-3955(05)70180-2" @default.
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