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


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Parker
Robyn
R
Department of Emergency Medicine, Northern Hospital, Cardiff, UK.
Powell
Colin V
CV
Kelly
Anne-Maree
AM
D000284:Administration, Oral; D002648:Child; D002675:Child, Preschool; D003440:Croup / Q000188:drug therapy*; D004630:Emergencies; D005938:Glucocorticoids / Q000008:administration & dosage / Q000494:pharmacology*; D006801:Humans; D007223:Infant; D015588:Observer Variation; D011239:Prednisolone / Q000008:administration & dosage / Q000494:pharmacology*; D012135:Respiratory Sounds / Q000187:drug effects*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013997:Time Factors
D005938:Glucocorticoids; D011239:Prednisolone