title: Viral croup: diagnosis and a treatment algorithm.
abstract: Viral croup is a frequent disease in early childhood. Although it is usually self-limited, it may occasionally become life-threatening. Mild croup is characterized by the presence of stridor without intercostal retractions, whereas moderate-to-severe croup is accompanied by increased work of breathing. A single dose of orally administered dexamethasone (0.15-0.6 mg/kg) is the mainstay of treatment with addition of nebulized epinephrine only in cases of moderate-to-severe croup. Nebulized budesonide (2 mg) can be given alternatively to children who do not tolerate oral dexamethasone. Exposure to cold air or administration of cool mist are treatment interventions for viral croup that are not supported by published evidence, but breathing heliox can potentially reduce the work of breathing related to upper airway obstruction. In summary, corticosteroids may decrease the intensity of viral croup symptoms irrespective to their severity on presentation to the emergency department.
authors.affiliation: Cystic Fibrosis Center, Aghia Sophia Children's Hospital, Athens, Greece.
authors.forename: Argyri
authors.initials: A
authors.lastname: Petrocheilou
authors.forename: Kalliopi
authors.initials: K
authors.lastname: Tanou
authors.forename: Efthimia
authors.initials: E
authors.lastname: Kalampouka
authors.forename: Georgia
authors.initials: G
authors.lastname: Malakasioti
authors.forename: Christos
authors.initials: C
authors.lastname: Giannios
authors.forename: Athanasios G
authors.initials: AG
authors.lastname: Kaditis
mesh_terms: D000280:Administration, Inhalation; D000284:Administration, Oral; D000465:Algorithms; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D019819:Budesonide / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003440:Croup / Q000175:diagnosis / Q000188:drug therapy*; D003907:Dexamethasone / Q000627:therapeutic use*; D006371:Helium / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D010100:Oxygen / Q000627:therapeutic use*; D064705:Racepinephrine / Q000627:therapeutic use*; D012720:Severity of Illness Index
chemical_list: D000893:Anti-Inflammatory Agents; D001993:Bronchodilator Agents; D006371:Helium; D019819:Budesonide; C038949:heliox; D003907:Dexamethasone; D064705:Racepinephrine; D010100:Oxygen
keywords: budesonide; dexamethasone; laryngotracheitis; laryngotracheobronchitis; racemic epinephrine; stridor