title: Clinical inquiries. What's best for croup?
abstract: A single dose of corticosteroids is the first-line treatment for croup, resulting in fewer return visits and hospital admissions, shorter lengths of stay in the emergency department (ED) or hospital, and less need for supplemental medication (strength of recommendation [SOR]: A, meta-analysis and randomized controlled trials [RCTs]). A 0.15 mg/kg dose of oral dexamethasone is as effective as larger doses (SOR: B, small RCTs).Nebulized racemic or L-epinephrine reduces severity of symptoms in moderate-to-severe croup (SOR: C, limited-quality disease-oriented evidence).The role of heliox in moderate to severe croup remains uncertain. Studies to date have been inadequate (SOR: C, limited-quality disease-oriented evidence).Humidified air provides no demonstrable benefit in the acute setting (SOR: A, meta-analysis).
authors: Swedish Family Medicine Residency-First Hill, Seattle, WA, USA.
authors: Jessica Danielle
authors: JD
authors: Pitluk
authors: Howard
authors: H
authors: Uman
authors: Sarah
authors: S
authors: Safranek
mesh_terms: D000280:Administration, Inhalation; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D003440:Croup / Q000628:therapy*; D004837:Epinephrine / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use; D006371:Helium / Q000627:therapeutic use; D006801:Humans; D010100:Oxygen / Q000627:therapeutic use; D010102:Oxygen Inhalation Therapy; D017410:Practice Guidelines as Topic; D012138:Respiratory Therapy
chemical_list: D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D006371:Helium; C038949:heliox; D010100:Oxygen; D004837:Epinephrine