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Croup.

David Johnson¹

¹Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.

BMJ Clinical Evidence

|May 19, 2009

Summary

This summary is machine-generated.

This systematic review evaluates treatments for croup in children. It found various interventions, including corticosteroids and nebulized adrenaline, effective for managing mild to severe cases and respiratory failure.

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Area of Science:

Pediatrics
Infectious Diseases
Respiratory Medicine

Background:

Croup causes upper airway obstruction in children, primarily aged 6 months to 3 years.
Parainfluenza virus is responsible for 75% of croup infections, with most cases resolving within 48 hours.
Severe croup can rarely lead to pneumonia, respiratory failure, and arrest, necessitating differentiation from epiglottitis or foreign body aspiration.

Purpose of the Study:

To systematically review and evaluate the effects of various treatments for children with mild, moderate to severe, or impending respiratory failure due to croup.
To assess the effectiveness and safety of interventions for different severities of croup.

Main Methods:

A systematic review was conducted, searching major databases up to June 2008.
Included studies were systematic reviews, randomized controlled trials (RCTs), and observational studies.
GRADE evaluation was used to assess the quality of evidence for interventions.

Main Results:

43 systematic reviews, RCTs, and observational studies met the inclusion criteria.
Evidence was evaluated for interventions including antibiotics, corticosteroids (dexamethasone, budesonide), nebulized adrenaline, heliox, and oxygen.
The review presents information on the effectiveness and safety of these interventions.

Conclusions:

The systematic review synthesizes evidence on the effectiveness and safety of numerous interventions for pediatric croup.
Interventions discussed include corticosteroids, nebulized adrenaline, heliox, humidification, and oxygen.
The findings aim to inform clinical decision-making for managing croup in children across a spectrum of severity.