Original contributionRacemic epinephrine use in croup and disposition☆
References (11)
The treatment of croup: Continued controversy due to failure of recognition of historic, ecologic, etiologic and clinical perspectives
J Pediatr
(1979)- et al.
Nebulized racemic epinephrine by IPPB for the treatment of croup
Am J Dis Child
(1978) - et al.
Racemic epinephrine in the treatment of croup: Nebulization alone versus nebulization with intermittent positive pressure breathing
J Pediatr
(1982) - et al.
A prospective randomized double-blind study to evaluate the effect of dexamethasone in acute laryngotracheitis
J Pediatr
(1989) - et al.
Treatment of laryngotracheobronchitis (croup)
Am J Dis Child
(1975)
Cited by (63)
SARS-CoV-2 and croup, not a rare coincidence
2022, American Journal of Emergency MedicinePediatric croup with COVID-19
2021, American Journal of Emergency MedicineCitation Excerpt :We are unaware of any reports of SARS-CoV-2 associated with stridor and croup. Croup (laryngotracheitis) is usually caused by viral infections (most commonly parainfluenza types 1 to 3) in the fall and winter months [6]. Croup typically presents with a “barky cough” and in more severe cases may develop stridor and dyspnea [7].
Inpatient Treatment after Multi-Dose Racemic Epinephrine for Croup in the Emergency Department
2015, Journal of Emergency MedicineCitation Excerpt :Although rebound stridor is the feared complication, patients relapse, at worst, to pretreatment levels of severity (2,5,6). After administration of corticosteroids and a single dose of RE, safe discharge from the emergency department (ED) is possible after an observation period of 2–4 h (7–11). Except for a single study describing the implementation of a clinical pathway that dictated disposition based on clinical response to treatment, little published evidence addresses hospital admission criteria (12–14).
CROUP (LARYNGITIS, LARYNGOTRACHEITIS, SPASMODIC CROUP, LARYNGOTRACHEOBRONCHITIS, BACTERIAL TRACHEITIS, AND LARYNGOTRACHEOBRONCHOPNEUMONITIS)
2009, Feigin and Cherry's Textbook of Pediatric Infectious Diseases, Sixth EditionLaryngitis-Diagnosis and Management
2008, Otolaryngologic Clinics of North AmericaCitation Excerpt :On the other hand, its mechanism of action remains unclear. While anti-inflammatory effects probably play a significant role, the rapid onset of action also suggests a possible role for vasoconstriction and reduced vascular permeability [1,11,14–16]. Oral and nebulized dexamethasone, nebulized budenoside, and oral prednisolone can all be used.
Croup
2008, The LancetCitation Excerpt :No children had adverse outcomes.47,124–127 This prospectively derived data along with findings of two retrospective cohort studies provide favourable support for children to be safely discharged home after treatment with epinephrine, as long as their symptoms have not recurred within 2–4 h of treatment.128,129 The administration of one dose at a time of nebulised epinephrine to children has not been associated with any adverse effects nor a clinically significant increase in either heart rate or blood pressure.76,99,117,118,123,130
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Presented to the Section on Emergency Medicine, American Academy of Pediatrics, Boston, October 1990.