A prospective, randomized double-blind study in children comparing two doses of nebulized L-epinephrine in postintubation croup.
OBJECTIVE
To compare the effectiveness and side effects of nebulized l-epinephrine (NLE) at a dose of 0.05 mL/kg versus 0.5 mL/kg in the treatment of postintubation croup in children.


METHODS
Thirty-nine children, who developed signs and symptoms of upper airway obstruction (UAO) after extubation, were randomized to receive either 0.05 mL/kg or 0.5 mL/kg of NLE. UAO scores, vital signs (VS) and possible side effects were recorded before and at 20 and 40 minutes after the treatment.


RESULTS
Twenty-one and 18 patients were allocated to the 0.05 and 0.5 mL/kg groups, respectively. Both groups showed improvements in UAO scores over time. There were no significant differences in UAO scores and VS between the groups at all time points. Side effects of epinephrine were not observed.


CONCLUSIONS
In children with postintubation croup, the administration of NLE at the dose of 0.05 mL/kg results in similar improvements in the UAO scores, compared with the dose of 0.5 mL/kg. No complications were seen in either dose.
Preutthipan
Aroonwan
A
Departments of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University Bangkok, Thailand.
Poomthavorn
Preamrudee
P
Sumanapisan
Apinya
A
Chinrat
Benchaporn
B
Thasuntia
Sriwanna
S
Plitponkarnpim
Adisak
A
Chantarojanasiri
Teerachai
T
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D000402:Airway Obstruction / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D003440:Croup / Q000188:drug therapy* / Q000209:etiology; D004359:Drug Therapy, Combination; D004837:Epinephrine / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D008297:Male; D009330:Nebulizers and Vaporizers; D011446:Prospective Studies; D014662:Vasoconstrictor Agents / Q000008:administration & dosage / Q000627:therapeutic use*
D000305:Adrenal Cortex Hormones; D014662:Vasoconstrictor Agents; D004837:Epinephrine